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Related Experiment Videos

Progressive heart block in active rheumatoid arthritis.

V Adhiyaman1, A Oke, K Aziz

  • 1Department of Geriatric Medicine, Wrexham Maelor Hospital, Wrexham, UK.

International Journal of Clinical Practice
|February 24, 2001
PubMed
Summary

Rheumatoid arthritis (RA) can cause severe heart complications, including complete heart block (CHB). CHB in RA patients may indicate advanced disease severity and requires careful cardiac monitoring.

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Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints but can lead to systemic complications.
  • Extra-articular manifestations in RA can involve various organs, including the cardiovascular system.
  • Cardiac involvement in RA can range from pericarditis to conduction abnormalities.

Observation:

  • A 68-year-old female patient with active RA and severe extra-articular features developed progressive cardiac conduction abnormalities.
  • Her electrocardiogram (ECG) showed a transition from normal sinus rhythm to left bundle branch block, and ultimately to complete heart block (CHB).
  • Cardiovascular investigations excluded an ischemic etiology for the observed heart block.

Findings:

  • The patient required a permanent pacemaker due to symptomatic heart failure secondary to CHB.

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  • Following pacemaker insertion, the patient experienced an uneventful recovery.
  • Complete heart block in the context of rheumatoid arthritis is suggested to be a potential marker of disease severity.

    • Implications:

    • This case highlights the critical need for vigilant cardiovascular monitoring in RA patients, particularly those with severe or extra-articular disease.
    • Complete heart block may serve as an indicator of advanced rheumatoid arthritis, prompting a reassessment of disease activity and management strategies.
    • Early recognition and intervention for cardiac complications in RA can lead to improved patient outcomes.