Chronic Constrictive Pericarditis in Association with Rheumatoid Disease

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Abstract
A case of constrictive pericard-itis in a patient with rheumatoid arthritis is described. Positive latex fixation and nonnecrotizing vasculitis in a biopsy of pectoralis muscle supported the clinical impression of rheumatoid disease. Pericardectomy provided symptomatic and objective relief of pericardial constriction. In a review of recent large series of constrictive pericarditis a wide variety of etiologic agents was encountered, tuberculosis remaining the most common demonstrable etiology. Many cases of constrictive pericarditis must be classified as idiopathic. Although pericarditis without constriction occurs in up to 44% of autopsied patients with rheumatoid arthritis, only 6 patients with proven constriction were found described in the past 10 years. Under all etiologic conditions, only a few patients with acute pericarditis progress to constriction.