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[Rheumatoid aortic insufficiencies: severity of the prognosis].
1Service d'Immuno-Rhumatologie et Réadaptation Fonctionnelle, Hôpital Saint-Eloi, Montpellier.
Revue Du Rhumatisme Et Des Maladies Osteo-Articulaires
|October 1, 1992
Summary
Rheumatoid arthritis can cause severe aortic incompetence, a rare condition. This study highlights its aggressive nature and poor prognosis in seven patients with rheumatoid arthritis, emphasizing the need for early recognition.
Area of Science:
- Cardiology
- Rheumatology
- Pathology
Background:
- Rheumatoid aortic incompetence is a rare complication of rheumatoid arthritis.
- Only 43 cases have been previously reported in medical literature.
Observation:
- Seven new cases of rheumatoid arthritis with aortic incompetence are presented (5 females, 2 males).
- All patients had seropositive rheumatoid arthritis with severe joint disease and extraarticular manifestations.
- Aortic incompetence developed irrespective of patient age or rheumatoid arthritis duration.
Findings:
- The condition presented acutely with heart failure in three patients and was incidentally found in four.
- The disease course was severe, leading to a fatal outcome in five patients, with the youngest being 24.
- Mean survival was 20 months post-diagnosis and 11 months from heart failure onset.
- Histology revealed rheumatoid granuloma and inflammatory infiltrates in the pericardium and aortic valve of one patient.
Implications:
- Rheumatoid aortic incompetence represents a severe, often fatal, manifestation of rheumatoid arthritis.
- Early diagnosis and recognition of cardiac involvement in rheumatoid arthritis patients are crucial.
- Further research is needed to understand the pathogenesis and improve management strategies for this rare condition.