The British Journal of Rheumatology, Vol 36, 100-103, Copyright © 1997 by British Society for Rheumatology
ER McRorie, RA Wright, ML Errington and RA Luqmani
A 73-yr-old woman with a 4 yr history of rheumatoid arthritis presented
with the clinical features of congestive cardiac failure. She had a good
early response to standard therapy although she subsequently developed
recurrent biventricular failure. The preservation of good ventricular
function on echocardiography in the face of clinical evidence of myocardial
insufficiency raised the possibility of constrictive pericarditis, which
was confirmed on cardiac catheterization. Constrictive pericarditis should
be considered in patients with rheumatoid arthritis who develop unexplained
cardiac failure. Early diagnosis requires a high index of suspicion and
cardiac catheterization may be necessary to confirm the diagnosis. Medical
treatment is largely ineffective and pericardiectomy should be considered.
ORIGINAL PAPERS
Rheumatoid constrictive pericarditis
Department of Rheumatology, Western General Hospital, Edinburgh.
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