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[The heart and rheumatoid arthritis. Prospective study of 100 cases]
Insights
Cardiovascular complications are frequent in rheumatoid arthritis patients, with over half experiencing issues like pericardial effusion and heart failure. Early detection through non-invasive methods is crucial for managing rheumatoid arthritis complications.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory disease.
- Cardiovascular complications are a significant concern in RA patients.
- Previous studies suggest a link between RA and heart disease.
Purpose of the Study:
- To investigate the frequency and types of cardiovascular complications in RA patients.
- To assess the utility of non-invasive methods in detecting cardiac issues in RA.
Main Methods:
- Non-invasive cardiological assessment of 100 consecutive RA patients.
- Utilized cardiac X-ray, resting electrocardiogram (ECG), and M-mode echocardiogram.
- Clinical evaluation, physical examination, and laboratory tests (e.g., Waaler-Rose test).
Main Results:
- 57% of patients had cardiopulmonary complications; 52% reported symptoms.
- Common findings included pericardial effusion (21%), rhythm disturbances (22%), and conduction defects (20%).
- Higher incidence of certain complications (e.g., pulmonary fibrosis) noted compared to literature.
Conclusions:
- Cardiovascular complications are highly prevalent in severe, long-standing RA.
- Non-invasive methods effectively detect a range of cardiac issues in RA.
- RA patients, especially those with severe disease, require diligent cardiac monitoring.
Abstract:
We studied one hundred consecutive patients with rheumatoid arthritis from the cardiological point of view through non invasive methods to detect the frequency of cardiovascular complications. Seventy three (73%) were females and twenty seven (27%) males. Mean age, 48.6 years. Mean age of presentation of the disease, 34.2 years. Mean age of duration of the illness, 21.8 years. Fifty seven per cent had some type of cardiopulmonary complication. Clinically 52 per cent referred some type of cardiopulmonary symptoms. The physical examination was abnormal in 27 per cent. Rheumatoid factor (Waaler-Rose) was positive in 82 per cent. The cardiac X ray series was abnormal in 33 per cent, the resting electrocardiogram in 48 per cent and the M mode echocardiogram in 52 per cent of the cases. The complications detected were: pericardial effusion (21%); pleural effusion (9%); pulmonary fibrosis (6%) which represents a higher incidence of previously reported in the literature; congestive heart failure (10%); valvular lesion (9%) among those are included six patients with valvular heart disease of non detectable etiology; ischemic heart disease (8%); myocarditis (6%); rythm disturbances (22%) and conduction defects (20%) including a 46 year old female patient who developed a complete AV block during an exacerbation of her illness, requiring the insertion of definitive pacemaker. Our results showed that some of the detected lesions are in part more frequent and severe than those reported in the literature, probably due to, that on one hand their search was intentional and on the other, our group was constituted by with severe and long standing rheumatoid arthritis.