Cardiac complications in rheumatoid arthritis in the absence of occlusive coronary pathology

Abstract

Cardiovascular disease is the leading cause of premature mortality in patients with rheumatoid arthritis (RA). Pathophysiology of rheumatoid cardiovascular phenomenon is not fully understood, but systemic inflammation is thought to play a crucial role in the endothelial damage and accelerated course of atherosclerotic disease. Rheumatoid inflammation can also cause coronary pathology and heart failure. We present a case of transient cardiomyopathy in RA in the absence of occlusive coronary pathology, which mimics acute coronary syndrome.

Churg-Strauss Syndrome Accompanied by Acute Coronary Syndrome in the Absence of Coronary Atherosclerosis

“…Other rheumatic disorders can also present with coronary vasculitis, which can lead to coronary spasms and/or thrombosis. [6,7] Immunosuppressive treatment with corticosteroids can result in the improvement of impaired cardiac contractility and resolution of pericardial effusions, and this is exactly what happened with our patient after the control echocardiography revealed normal morphology of the ventricles without segmental wall motion abnormality along with no pericardial effusion.…”

Takotsubo cardiomyopathy and thrombotic thrombocytopenic purpura preceding a lupus diagnosis: a case report

“…1,3 The aetiology of this self-limiting cardiomyopathy remains unclear, apart from the clear trigger association with stress, either emotional or physical. 2,3 As mentioned previously, Takotsubo cardiomyopathy has been observed in other rheumatic conditions 5,6 and in three patients with SLE; however, in all three cases the diagnosis of SLE preceded the diagnosis of the cardiomyopathy. Moreover, other cardiovascular risk factors, such as hypertension, 2 antiphospholipid syndrome 3 and obesity, 4 were present in these cases.…”

“…2–4 Thrombotic thrombocytopenic purpura (TTP) has been associated with a number of autoimmune disorders, including SLE. 5,6 We report a very unusual case where a postmenopausal woman presented initially with Takotsubo syndrome, TTP without any clinical or laboratory features of SLE, but during the course of her illness was found to fulfil four of the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria 7 for SLE.…”

Pericarditis-complicated takotsubo cardiomyopathy in a patient with rheumatoid arthritis

“…Several reports have described concomitant TTC and pericarditis, but the pathogenesis of the association between TTC and pericarditis remains unclear (1)(2)(3). On the other hand, an association of TTC with autoimmune disorders has been reported in the literature (4)(5)(6). Here, we present a case of TTC, complicated by pericarditis, in a patient with rheumatoid arthritis (RA).…”