A CASE REPORT OF MULTIPLE VALVULAR HEART DISEASE IN ULCERATIVE COLITIS AT OLUWAROTIMI SPECIALIST AND DIAGNOSTIC CENTRE AKURE, ONDO STATE. NIGERIA

Folorunso Timothy Oluwarotimi*, Kenechukwu Okonkwo, Pelemo Olumuyiwa, Tawose Olamide Oluwabukunmi

ABSTRACT

Background: High index of suspicion is key to accurate clinical diagnosis. Case report: A 65 years old man presented with recurrent history of fatique, cough, palpitation and abdominal pain with associated passage of loose, mucoid and bloody stool. There is history of weight loss, anorexia, low grade fever and migratory myalgia and athralgia. He is not hypertensive, diabetic, asthma or peptic ulcer disease patient. He presented in shock with cold clammy extremities and sweaty with tachycardia 108/m regular and small volume, blood pressure of 80/50mmHg, elevated JVP and heart sound s1 s2 s3 with mitral, aortic and tricuspid regurgitant murmurs. There was bibasal rales and tender hepatomegaly. Echocardiography revealed preserved systolic function, bi ventricular diastolic dysfunction, left ventricular concentric hypertrophy and calcific degenerative changes involving both aortic and mitral valve with severe aortic, mitral and mild tricuspid regurgitation. Lower G I endoscopy revealed pan colitis and internal haemorrhoid. Histologic revealed mucosal infiltrations of inflammatory cells, focal areas of crypt abscess admixed with congested vessels. Conclusion: Inflammatory bowel disease; ulcerative colitis is a rare condition in our environment. No wonder the index case has been in and out of several health facility without respite.

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