Rheumatoid Pericarditis

Seventeen patients with rheumatoid pericarditis, diagnosed clinically, are compared with 41 cases reported in the literature and with 85 control patients with rheumatoid arthritis but without pericarditis. Rheumatoid pericarditis occurred in patients with definite or classical rheumatoid arthritis. Rheumatoid factor, present in 93% of the patients tested, was statistically commoner than in the control group. Subcutaneous nodules were present in 47%. The presenting complaints were left-sided chest pain (59%) and symptoms of congestive heart failure (18%). A pericardial friction rub was detected in 65%. All patients had cardiomegaly, as seen by X ray, accompanied by pleural effusion in 65%. A low sugar concentration in the pericardial fluid, elevated lactic dehydrogenase and gamma globulin levels, and, probably, a low complement value indicate rheumatoid arthritis as the most probable cause of the effusion. Over one third of the pericarditis patients eventually required pericardiectomy or died of their disease.