Is there a relationship between RA and pericardial effusion?Is there a relationship between RA and pericardial effusion?

Because of details in a CT scan for kidney stones, I was directed to get an echocardiogram and my first ever visit to a cardiologist. It turns out I have a pericardial effusion around my heart. I have had 4 other echos during the year since then and the results are the same. The water is still there, this is not normal we are just keeping an eye on it. The cardiologist says the RA could be contributing to the situation but there is not a way to know that for sure. My rehumatologist asks if the cardio doc thinks he should stop up my treatment and I have not found anything to read about the situation. I have stellar cholesterol numbers, my heart valves are working fine, blood flow and heart muscle are great. I take a "cocktail" of meds for my RA plaquenil, methotrexate, prednisone and sulindac which keeps the symptoms in control.
Do you know if there is a direct link from my effusion to my RA? Any questions that I should ask either specialist to pinpoint treatments? I see my rheumatologist 4 times a year, but have only been seen by the cardiologist the one time--I have an annual appt with her in mid February.

Answers from our Doctors

tshaver's picture
Dr. Timothy S. Shaver says:

A small subset of rheumatoid arthritis patients will demonstrate a pericardial effusion, or more commonly fluid around the lungs, known as a pleural effusion. It sounds as if there are no other obvious causes for the pericardial effusion given your otherwise good health status, so it would be reasonable to conclude that the fluid is due to your rheumatoid arthritis. We could make a more compelling argument for this if you arthritis were also active and inadequately controlled, but this complication can occur even when the joint disease is stable. As long as the fluid is not causing pain or compromising the heart muscle function, it does not need to be addressed specifically but should be watched, which is what your cardiologist is doing. I would want to know if she saw any reason to aspirate the fluid for diagnostic studies (if there is enough fluid to safely aspirate). The other concern is that chronic inflammation around the pericardium can rarely result in something called constrictive pericarditis, and this can compromise heart function. I would also ask your cardiologist if she saw this as a possibility that concerns her. Best wishes!

Answered on: Thursday, February 2, 2012 - 21:04


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