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[Pericarditis with recurrent cardiac compression in rheumatoid polyarthritis]
La Semaine Des Hopitaux : Organe Fonde Par L'Association D'Enseignement Medical Des Hopitaux De Paris
|November 10, 1983
Summary
Rheumatoid arthritis can cause pericarditis, leading to heart failure. Recurrent pericarditis, even with treatment, may indicate underlying infections like tuberculosis, especially in immunocompromised patients.
Area of Science:
- Cardiology
- Rheumatology
- Infectious Diseases
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints but can have systemic manifestations.
- Pericarditis, inflammation of the pericardium, can be a rare but serious complication of RA.
- Right ventricular failure can be an indicator of cardiac involvement in systemic diseases.
Observation:
- A 72-year-old male with severe rheumatoid arthritis presented with right ventricular failure, revealing underlying pericarditis.
- Pericardial fluid analysis and histological examination suggested a rheumatoid etiology for the pericarditis.
- The patient experienced recurrent pericarditis with subacute cardiac compression despite corticosteroid therapy.
Findings:
- The initial presentation was attributed to rheumatoid pericarditis, confirmed by fluid and tissue analysis.
- Recurrence of pericarditis occurred 2.5 years later, leading to cardiac tamponade.
- Mycobacterium tuberculosis was suspected in the terminal stage but not definitively confirmed.
Implications:
- This case highlights the importance of considering rheumatoid pericarditis in RA patients with cardiac symptoms.
- Recurrent pericarditis, particularly under immunosuppressive therapy, warrants investigation for opportunistic infections like tuberculosis.
- Early diagnosis and management of rheumatoid pericarditis are crucial to prevent cardiac complications.