Cardiac Valvular Lesions in Rheumatoid Arthritis

Nodules, occur in the subcutaneous tissue, also may occur in the respiratory, intestinal hematopoietic, musculoskeletal, and cardiac systems of patients with rheumatoid arthritis (RA). Recently, we described rheumatoid nodules in all four cardiac valves of a 65-year-old woman with RA.1Since that report was submitted for publication, which was the first report to describe significant quadrivalvular involvement in RA, we have observed similar quadrivalvular cardiac disease in another patient who died with RA. This paper describes the cardiac lesions in the latter patient, and compares them with those found in the previously described subject and with those observed in the more frequent types of valvular heart disease. Patient Summary A 72-year-old man (GMC, 12-47-82) who died Nov 28, 1966, was well until age 36 when he suddenly developed right-sided pleuritis with effusion, and several days later, swelling, redness, pain, and tenderness of both ankles and the metatarsophalangeal joints of