RHEUMATOID-ARTHRITIS AS A CAUSE OF CARDIAC COMPRESSION - FAVORABLE LONG-TERM OUTCOME OF PERICARDIECTOMY

In order to clarify the significance of rheumatoid arthritis (RA) as a cause of cardiac compression, we scrutinized pericardiectomy riles of 47 patients over a ten-year period at two university hospitals in Fin land. Five patients with RA were found. All the patients with RA were men with seropositive disease and subcutaneous rheumatoid nodules. Two of the patients had pulmonary fibrosis, one had cutaneous vasculitis and three had had rheumatoid pleurisy. There was a mean delay of 10 mo nths from the first cardiac symptom to the diagnosis of cardiac compre ssion, the most common misdiagnosis being primarily a liver disease. O n the basis of clinical and operative data, four out of the rive patie nts had constrictive pericarditis and one had an effusive-constrictive form of the disease. The histopathological findings in all cases were consistent with chronic fibrosing pericarditis. A follow-up of seven to seventeen years of four patients has not revealed any signs of recu rrent pericardial disease. Our results demonstrate that RA is an impor tant aetiological factor for cardiac compression. The long-term outcom e of this manifestation seems to be good after pericardiectomy.