Chronic Constrictive Pericarditis in Association with Rheumatoid Disease

THE ASSOCIATION of rheumatoidstates with pericarditis is known."2Coincidence of rheumatoid arthritis and chronic constrictive pericarditis is uncom- mon and represents a fascinating study in the pathogenesis of pericardial constriction.Repeated episodes of acute pericarditis asso- ciated with migratory polyarthritis and gradual development of constrictive pericarditis can seldom be documented.A patient with this disease patteril was seen recently at the Cincinnati Veterans Administration Hospital and successfully treated.Description of this patient's clinical course along with a discussion of the relationship between rheu- matoid disease and pericarditis constitutes the basis of this report.The etiology and incidence of constrictive pericarditis in gen- eral are briefly reviewed. Report of a CaseA 40-vear-old white farmer was admitted to the Cincinnati Veterans Administration Hospital on January 6, 1961.He complained of weakness, dyspnea, dull anterior chest pain, and swelling of his legs for 1 week.He had had a severe "head and chest cold," with productive cough 10 days prior to admission.He had received three injections of penicillin and streptomycin, and his cough became nonproductive but persistent.He had had a full sensation in his epigastrium for several weeks, and this feeling had been aggravated by eating.For 2 years prior to admission, the patient had had intermittent migratory joint pain, involving his wrists, shoulders, and hands.At times his fingers were noticeably swollen and difficult to move.He described no nodules or redness around his joints.There had been no antecedent sore throat at the time of joint swelling.Six months prior to admission he had experi- enced sudden, severe, anterior chest pain, which caused him to sit erect in a chair all night long.