EJMCR |

Case Report

Volume: 2 | Issue: 3 | Published: Jan 01, 1970 | Pages: 121 - 125 | DOI: 10.24911/ejmcr/173-1530701583

Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report

Authors: Giuseppe Cocco

Article Info

Authors

Giuseppe Cocco

Cardio-Rheumatology Office, Marktgasse, Rheinfelden, Switzerland

ORCID

Publication History

Received: July 04, 2018

Revised: September 16, 2018

Accepted: October 02, 2018

Published: January 01, 1970

Abstract

Background: Rheumatoid arthritis (RA) is an immune-related inflammatory disease which affects almost 1% of the general population and which is ranked among the top 15% of diseases causing major disability worldwide. RA shares some pathologic features, genetic predisposition, and risk factors with atherosclerosis, and inflammation plays a central pathophysiologic role in both diseases. RA is associated with an increased risk of cardiovascular mortality. In RA, pericardial involvement is a frequent complication but rarely occurs as the first manifestation. Case Presentation: A 63-year-old male patient with RA presented with an acute chest pain and in the Electrocardiography (ECG) ischemic ST-down-sloping in multiple leads. Echocardiography showed an abnormal "bounce" of the interventricular septum and a small-medium size pericardial effusion. The laboratory values showed high inflammatory parameters and confirmed the presence of active RA. Troponin T was normal and NT-proBNP was at level 2. There were no signs for vasculitis. Coronarography found only small non-stenotic changes in the coronary arteries. A rheumatologic consultant recommended prednisone and later on, tocilizumab. He was also treated with colchicine. The clinical condition improved within 2 weeks and the ECG changes normalized within a month. Three months later, an echocardiographic follow-up showed that the pericardial effusion and the left ventricular bounce had disappeared. Conclusion: Small-medium size pericardial effusion manifesting as an acute coronary syndrome and with ischemic ECG changes is the most unusual finding. Indeed, the proper diagnosis of a pericardial effusion was made retrospectively

Keywords: Pericardial effusion, rheumatoid arthritis, acute chest pain, atypical ECG changes, green

Pubmed Style

Giuseppe Cocco. Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report. EJMCR. 1970; 01 (January 1970): 121-125. doi:10.24911/ejmcr/173-1530701583

Web Style

Giuseppe Cocco. Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report. https://ejmcr.com/articles/1518 [Access: December 04, 2024]. doi:10.24911/ejmcr/173-1530701583

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Giuseppe Cocco. Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report. EJMCR. (1970), [cited December 04, 2024]; 01 (January 1970): 121-125. doi:10.24911/ejmcr/173-1530701583

Harvard Style

Giuseppe Cocco (1970) Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report. EJMCR, 01 (January 1970): 121-125. doi:10.24911/ejmcr/173-1530701583

Chicago Style

Giuseppe Cocco. "Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report." 01 (1970), 121-125. doi:10.24911/ejmcr/173-1530701583

MLA (The Modern Language Association) Style

Giuseppe Cocco. "Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report." 01.January 1970 (1970), 121-125. Print. doi:10.24911/ejmcr/173-1530701583

APA (American Psychological Association) Style

Giuseppe Cocco (1970) Unusual electrocardiographic changes in a patient with pericardial effusion caused by rheumatoid arthritis: a case report. , 01 (January 1970), 121-125. doi:10.24911/ejmcr/173-1530701583