CARDIAC INVOLVEMENT IN JUVENILE RHEUMATOID ARTHRITIS

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Abstract
Cardiac involvement was diagnosed in 15 of 320 cases of JRA [juvenile rheumatoid arthritis] (4.7%) and was most frequent in children with acute systemic disease. Ten children had pericarditis, 2 had myocarditis, 2 had peri-myocarditis and 1 had aortic valvulitis. The highest risk of heart involvement was found during the first 3 yr but it could occur at any time. Recurrent episodes were seen in 60% of cases. The prognosis in pericarditis seems to be good since no patient developed cardic tamponade or constrictive pericarditis and cardiac function evaluated by echocardiography was normal in all patients at follow-up. In patients with myocarditis and peri-myocarditis, a dilated left ventricle was found in 2 of 4 patients, and 1 patient who died had severe cardiac changes at autopsy. The prognosis in myocarditis thus seems to be worse. In valvulitis the prognosis depends on which valve is involved. The benefit of early treatment with corticosteroids is discussed.

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