Rheumatoid Arthritis and the Heart

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is different from osteoarthritis. RA causes hot and swollen joints, pain, stiffness, and if not treated, deformed joints. It usually affects the fingers, wrists, elbows, shoulders, jaw, hips, knees, and toes. It affects 2 to 3 times as many women as men.

How does it occur?

RA is thought to be an autoimmune disease, a disease in which the body attacks its own tissues. It may run in families.

How does it affect the heart?

RA appears to increase the risk of developing heart disease. This makes it especially important for people with RA to quit smoking and control high blood pressure and high cholesterol.

The rheumatoid process can cause an inflammation of the pericardium (tissue sac covering the heart). This inflammation (pericarditis) usually causes no symptoms and needs no treatment. In rare cases, the inflammation may cause fluid to build up in the sac. The fluid may need to be drained for the heart to work normally.

RA may also cause little bumps or nodules to form in the tissue of the heart valves. Rarely, these nodules deform the valve and cause it to leak. Most of these leaks are tiny and do not affect the way the heart works.

What are the symptoms?

Rheumatoid arthritis rarely causes heart symptoms. There may be chest pain and or shortness of breath from pericarditis.

How is it diagnosed?

Pericarditis causes the heart to make a certain sound your doctor can hear with a stethoscope. An echocardiogram, or ultrasound picture of the heart, will show if pericardial fluid is present.

How is it treated?

There is no treatment known to keep rheumatoid arthritis from affecting your heart. Pericarditis is treated effectively with anti-inflammatory drugs. Valve problems may be treated with surgery.