Clinical consequences of the cardiac manifestations of Rheumatoid Arthritis

What are the clinical consequences of the cardiac manifestations of Rheumatoid Arthritis?

PericarditisPain (1% of rheumatoid arthritis patients)
Tamponade (rare)
Constriction (uncommon)
NodulesConduction abnormalities
Valvular problems
Coronary arteritisMyocardial infarction
MyocarditisCongestive heart failure

Historically, pericarditis is the most common cardiac manifestation of RA and is present in up to 50% of patients at autopsy, although the rates of pericardial disease with modern therapy are less well understood. It usually manifests as asymptomatic pericardial effusions, which may be detected by echocardiography or on chest imaging (e.g., computed tomography). These effusions are rarely large enough to cause tamponade but may result in constrictive pericarditis late in the course of the disease. Constrictive pericarditis must be treated with a pericardiectomy because it is fibrous and unresponsive to immunosuppressive medications. RA may also cause nodules to form in and around the heart, leading to conduction defects and occasionally valvular insufficiency.


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