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Angiology
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Acute Congestive Heart Failure Due to the Arteritis of Rheumatoid Arthritis: Early Diagnosis by Endomyocardial Biopsy

A Case Report

John D. Slack

Cardiology Section, Department of Medicine, Saint Vincent Hospital, Department of Pathology, Indiana University Medical Center, Indianapolis, Indiana

Bruce Waller

Cardiology Section, Department of Medicine, Saint Vincent Hospital, Department of Pathology, Indiana University Medical Center, Indianapolis, Indiana

A 49-year-old man with rheumatoid arthritis presented with acute conges tive heart failure. Acute viral myocarditis was suspected clinically as a Gallium- 67 myocardial scan was positive. Percutaneous catheter-directed biopsy of the right ventricular endomyocardium, however, revealed heavy endothelial de posits of I gM in the small blood vessels of the myocardium. Prednisone therapy resulted in normalization of both the myocardial Gallium-67 scan and left ven tricular ejection fraction with resolution of the symptoms of congestive heart failure. This is the first report documenting rheumatoid arteritis antemortem by myocardial biopsy.

Angiology, Vol. 37, No. 6, 477-482 (1986)
DOI: 10.1177/000331978603700609
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