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Rheumatoid pericarditis: clinical features and survival.
K S Hara1, D J Ballard, D M Ilstrup
1Division of Thoracic Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Medicine
|March 1, 1990
Summary
Patients with rheumatoid arthritis and pericarditis face reduced survival, particularly in the first year post-diagnosis. Factors like older age and heart disease worsen prognosis for rheumatoid arthritis patients with pericarditis.
Area of Science:
- Rheumatology
- Cardiology
- Clinical Epidemiology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints but can involve extra-articular manifestations, including cardiac complications.
- Pericarditis, inflammation of the pericardium, can occur in RA patients and impact their clinical course and survival.
Purpose of the Study:
- To characterize the clinical features of rheumatoid arthritis patients with pericarditis.
- To determine the survival rates and prognostic factors in this patient cohort.
Main Methods:
- Retrospective analysis of 41 consecutive rheumatoid arthritis patients with clinical pericarditis diagnosed between 1970 and 1987 at the Mayo Clinic.
- Actuarial survival analysis compared to an age- and sex-matched general population.
Main Results:
- The cohort predominantly experienced acute pericarditis (75%). Common RA features included symmetrical joint swelling and rheumatoid factor; extra-articular signs like fatigue and weight loss were frequent.
- Cardiac manifestations included dyspnea, pericardial pain, edema, tachycardia, and abnormal echocardiograms. Elevated ESR and anemia were common laboratory findings.
- Survival was significantly decreased compared to the general population, especially within the first year. Factors associated with poorer survival included older age, co-existing heart disease, more extra-articular manifestations, jugular venous distention, and lower blood pressure.
Conclusions:
- Rheumatoid arthritis patients with pericarditis have a poorer prognosis than the general population.
- Clinical indicators such as advanced age, concurrent heart disease, and specific physical findings (jugular venous distention) predict reduced survival in this population.
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