Cardiac compression in rheumatoid pericarditis

Agustin Escalante, Ronald L. Kaufman, Francisco P. Quismorio, Thomas D. Beardmore

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Rheumatoid pericarditis occurs in approximately one third of rheumatoid arthritis (RA) patients. However, clinically apparent rheumatoid pericarditis is infrequent. The authors found clinical pericarditis in 12 of 960 patients admited for RA, 5 of whom had manifestations of cardiac compression. These 5 had longer duration of RA, worse functional class, and more extraarticular features than the patients without cardiac compression. Presenting features of cardiac compression included dyspnea, edema, chest pain, and pulsus paradoxus. Treatment of patients with cardiac compression due to rheumatoid pericarditis may include a trial of systemically administered corticosteroids, but this should not delay surgical intervention for impending tamponade. Pericardiocentesis should only be performed as an emergency, life-saving procedure. It may be followed by intrapericardiac injection of corticosteroids, but this does not prevent recurrence. Longer-lasting benefit is obtained by surgical decompression. Two-year mortality in patients with cardiac compression was 100%. The literature on the subject is reviewed.

Original languageEnglish (US)
Pages (from-to)148-163
Number of pages16
JournalSeminars in Arthritis and Rheumatism
Volume20
Issue number3
DOIs
StatePublished - Dec 1990
Externally publishedYes

Keywords

  • Pericardial effusion
  • cardiac tamponade
  • constrictive pericarditis
  • rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine

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