Constrictive Pericarditis in Association with Rheumatoid Arthritis

Constrictive pericarditis has been regarded as almost invariably tuberculous in origin; in 1948 Andrews, Pickering, and Sellors stated, 'In Great Britain most, perhaps all, of the cases of constric- tive pericarditis are due to antecedent acute tuberculous pericarditis'.With the decline in the prevalence of tuberculosis, other causes of constrictive pericarditis may assume greater importance.Recently, Connolly and Burchell (1961) and Robertson and Arnold (1962) have drawn attention to the occurrence of constrictive pericarditis following acute non-specific (possibly virus) types of pericarditis.A few cases have been reported of constrictive pericarditis in association with rheumatoid states (McMurray, Cayer, and Cornatzer, 1951 ; Gimlette, 1959; Keith, 1962; Partridge and Duthie, 1963).We report here three further cases of constrictive pericarditis in patients with rheumatoid disease.CASE REPORTS CASE 1 V. P. was aged 31 at the time of her admis- sion to the Brompton Hospital in May, 1960.At the age of 19 she had developed severe arthritis of all joints, and at 23 she suffered from corneal ulcera- tion.At the age of 30 she had a severe staphylococcal chest infection, for which she was admitted to another hospital.About four months after this she developed dyspnoea on exertion and swelling of the ankles.the site of greatest thickening there was, in some places, yellow serous material between the two layers of the pericardium, and the visceral layer was oede- matous and difficult to dissect off the heart.