Rheumatoid pancarditis in a patient with well controlled rheumatoid arthritis

Significant rheumatoid cardiac disease usually occurs in the presence of active extraarticular disease, high titer rheumatoid factor, and systemic vasculitis. We report a patient who died of severe, widespread intracardiac rheumatoid disease, with none of these hallmarks present. The inflammatory infiltrate was centered on the collagenous skeleton of the heart; such a predilection has not been previously reported.