new_n_lost
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A 52-year-old woman has long-standing rheumatoid arthritis (RA) and is being treated with corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following cardiac complications may arise in this clinical setting?
A. Constrictive pericarditis
B. Dilated cardiomyopathy
C. Hypersensitivity myocarditis
D. Hypertrophic cardiomyopathy
E. Restrictive cardiomyopathy
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| me007
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d?
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| silver
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A. constrictive pericarditis
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| mytime
Kick my butt!
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E........RA?
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| afrocaribb
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hmmm good question, i think due to use of steriod, the pt is predisposed to infections and afterwards would result in a constrictive pericardities, but i dont know if that is right
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| monam84
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E
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| arlete
Intern in 2009!!!!!
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I think it's E because of amyloid deposition.
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| afrocaribb
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hmm yes i think Arlete is right , its restrictive due to deposition of Amyloid
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| Luckyall
Forum Guru
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E RCMP bc Cardiac Amyloidosis in this case is part of organ involvment in Systemic Amyloidosis derived from Serum Amyloid Associated SAA protein 
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| new_n_lost
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Luckyall ................... Bang on target
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| new_n_lost
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The correct answer is E.
What links rheumatoid arthritis (RA) to restrictive cardiomyopathy? Amyloid! Long-standing inflammatory conditions such as RA are associated with deposition of a form of amyloid known as AA (amyloid-associated protein), which may involve kidneys, heart, liver, skeletal muscle, and skin, for example. Amyloid deposition in the myocardium results in decreased compliance and impaired diastolic filling, i.e., restrictive cardiomyopathy. The myocardium has a rigid and waxy texture. This form of amyloid, as well as any other biochemical form, can be visualized on tissue section by staining with Congo red, which acquires a characteristic apple-green birefringence under polarized light.
Constrictive pericarditis (choice A) is due to any pathologic process that results in fibrous thickening of the pericardium, with resultant impaired compliance. Clinically, therefore, this condition manifests with a picture similar to restrictive cardiomyopathy because of impaired diastolic filling. Constrictive pericarditis is usually caused by previous episodes of acute pericarditis, especially hemorrhagic, suppurative, and caseous pericarditis.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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