Pericardial effusion in patients of rheumatoid arthritis

Objectives: pericardial effusion a cardiovascular manifestation of rheumatoid arthritis has never been studied before therefore this study was designed to evaluate it in patients suffering from rheumatoid arthritis. materials and methods: sixty patients of rheumatoid arthritis presenting in out patient,emergency and rheumatology clinic of mayo hospital lahore and emergency department of the punjab institute of cardiology lahore from march 1998 till january 2001 were studied. all of them full filled the criteria for the diagnosis of rheumatoid arthritis as described by the american rheumatism association. after history and physical examination,a clinical assessment of the patient was made of whether he / she had cardiac manifestations of rheumatoid arthritis or not. results: out of 60 patients seen 42(70%) were female,and 18(30%) were male. giving a female to male ratio of 2.3 to 1. maximum number of patients seen were between 26 - 45 years i.e 38(63.3%) in which 22 (36.6%) were between 26 to 35 years and 16 (26.6%) were between 36-45 years. next most frequent group was of 10(16.6%) patients,between 15-25 years of age. short systolic murmurs were heard in four patients. three patients showed pulsus paradoxus while in the rest no rhythm irregularity was felt. myocarditis or coronary rheumatoid disease was not noticed in any patient. no heart block of any degree was seen. in 6 patients low voltage electrocardiogram (ecg) was demonstrated in the limb leads. out of 60 patients only 5(8.3%) had pericardial effusion. in one patient it was only a thin rim more prominent posteriorly than anteriorly. conclusion: pericardial effusion is rare occurrence in patients of rheumatoid arthritis in pakistani population,although not with the same frequency as in the western world.