Rheumatoid valve lesions have been described for a long time in the literature. The authors report a case of rheumatoid aortic incompetence presenting with complete heat failure and treated semi-urgently by mechanical valve replacement. The pathological lesions observed on the aortic valves were pathognomonic of rheumatoid arthritis. Transthoracic echocardiography should be systematically proposed in the context of severe rheumatoid arthritis looking for valvular heart disease.