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Rheumatoid constrictive pericarditis

E R McRorie1, R A Wright, M L Errington

  • 1Department of Rheumatology, Western General Hospital, Edinburgh.

British Journal of Rheumatology
|January 1, 1997
PubMed
Summary

Rheumatoid arthritis patients experiencing unexplained heart failure may have constrictive pericarditis. Early diagnosis via cardiac catheterization is crucial, as medical treatments are often ineffective, and surgical pericardiectomy may be necessary.

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Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints but can have systemic manifestations.
  • Cardiac involvement in RA can range from valvular disease to myocarditis and pericarditis.
  • Congestive cardiac failure (CCF) is a potential complication, necessitating thorough etiological investigation.

Observation:

  • A 73-year-old female with a 4-year history of RA presented with symptoms of CCF.
  • Initial response to standard therapy for CCF was good, but recurrent biventricular failure developed.
  • Echocardiography revealed preserved ventricular function despite clinical signs of myocardial insufficiency.

Findings:

  • The discrepancy between preserved ventricular function and clinical heart failure suggested alternative diagnoses.

Related Experiment Videos

  • Cardiac catheterization confirmed constrictive pericarditis as the cause of the patient's cardiac failure.
  • Constrictive pericarditis is an underrecognized complication in RA patients presenting with unexplained cardiac failure.

    • Implications:

    • Clinicians should maintain a high index of suspicion for constrictive pericarditis in RA patients with unexplained cardiac failure.
    • Cardiac catheterization is a valuable diagnostic tool for confirming constrictive pericarditis.
    • Management strategies should consider the limited efficacy of medical treatment and the potential need for pericardiectomy.