Abstract 14871: Mitral Valve Involvement in Systemic Sclerosis, Post COVID-19 Infection

Abstract

Introduction: We report a case of mitral valve regurgitation as cardiac involvement of systemic sclerosis (SSc) in a 52-year-old woman post COVID-19 infection. Case Description: 52-year-old female presented with new-onset, progressive dyspnea, dryness and thickness of the skin, intermittent palpitations, and weight loss 3 months after recovered from COVID-19. Initial laboratory studies showed low hemoglobin levels and elevated pro-BNP, troponin-T, hs-CRP and ESR. An autoimmune panel was ordered and revealed positive antinuclear antibodies (ANA) and positive scleroderma related antibodies (anti-RNA polymerase III). Chest radiography and Chest CT without contrast both showed septal and bronchial wall thickening. A transthoracic echocardiogram was performed and showed a severely dilated left atrium and mildly thickened mitral valve leaflets with severe mitral regurgitation. A transesophageal echocardiogram revealed a thickened anterior mitral leaflet and restricted mobility of the posterior leaflet with mitral regurgitation being moderate in severity. These findings were consistent with the reported changes seen on echocardiogram and in autopsies in patients with SSc. The diagnosis of SSc in this patient was made and the patient was started on mycophenolate. Conclusions: This case highlights the possible mechanisms through which COVID-19 may trigger the development of autoimmune and inflammatory reactions which, in our case, lead to the development of mitral regurgitation as a sequela of SSc. Imagine 1. Imagine 2.