Background: We report an unusual case of rheumatoid arthritis presenting for the first time with pericardial constriction and bilateral pleural calcification, in the absence of prior articular disease.
Case Summary: A 46-year-old Caucasian male, who initially presented with shortness of breath, intermittent chest tightness and general malaise, underwent extensive diagnostic workup over a period of six months involving multiple hospital admissions. He was found to have pericardial constriction on echocardiogram and ultimately required surgical pericardiectomy due to decompensation. After multiple diagnostic tests and specialist opinion, the aetiology of pericardial disease was ultimately confirmed to be extra-articular rheumatoid disease without synovitis.
Discussion: Significant pericardial constriction can occur as the initial presentation of rheumatoid disease and anti-CCP is a highly specific confirmatory test. Pericardial pathological specimen can be unhelpful in determining this aetiology, and constrictive physiology can occur due to chronic inflammation/fibrosis in the absence of significant calcification.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375588 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytae428 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intrapericardial Corticosteroids and Colchicine Prevent Pericarditis and Atrial Fibrillation After Epicardial Ablation of Ventricular Arrhythmias.
JACC Clin Electrophysiol
January 2025
Cardiac Arrhythmia Service, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Background: Postprocedural pericarditis (PP) can occur in up to 29.4% of patients undergoing epicardial catheter ablation of ventricular tachycardia (VT). Despite several proposed strategies to mitigate this adverse outcome, rates of PP and pericarditic pain remain high.
View Article and Find Full Text PDFA very rare phenotype of immunoglobulin G4-related disease that was manifested as constrictive pericarditis: a case report.
Eur Heart J Case Rep
January 2025
Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Kyoto 629-0197, Japan.
Background: Constrictive pericarditis (CP) can arise from various causes, including post-operative degeneration, tuberculosis, and sequelae of pericarditis. Immunoglobulin (Ig) G4-related disease is a rare but recognized cause of CP. However, the specific mechanisms underlying these aetiologies and pathologies remain unclear.
View Article and Find Full Text PDFConstrictive pericarditis as first presentation of IgG4-related disease: pitfalls and pearls.
Mod Rheumatol Case Rep
December 2024
Department of Cardiology, Concord Hospital, The University of Sydney, Concord, NSW, Australia.
IgG-4 related disease (IgG4-RD) is an under recognised multisystem inflammatory disorder that has several typical manifestations. Cardiac manifestations of IgG4-RD are well documented however do not feature in the definition or diagnosis of IgG4-RD according to a recent consensus statement. The most well recognised cardiac manifestation of IgG4-RD, pericardial disease, is outlined in this case report as the initial presenting pathology.
View Article and Find Full Text PDFCardiovascular Involvement in Tuberculosis Patients Treated in Southern Africa.
JACC Adv
January 2025
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Background: Tuberculosis (TB) is the leading cause of death among people with HIV and a major global health challenge. Subclinical cardiovascular manifestations of TB are poorly documented in high TB and HIV burden countries.
Objectives: The purpose of this study was to quantify the prevalence of cardiovascular involvement in TB patients and investigate changes after completion of anti-TB treatment.
Pericardial effusion in an Indian context: clinical insights and dynamics from a tertiary care centre.
BMC Cardiovasc Disord
December 2024
Faculty of General Medicine, Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
Background: Pericardial effusion (PE) indicates the build-up of fluid within the pericardial sac, which encases the heart. The present study was undertaken to assess the clinical profile, etiology of pericardial effusion and to determine the correlation of cardiac tamponade and constrictive pericarditis with etiology.
Methods: A prospective observational hospital based longitudinal study was undertaken among the 88 newly diagnosed and known patients of pericardial effusion who are above 18 years.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!