A. S. ABBASI, M.D.
To the editor: The paper "Cardiac Involvement in Rheumatoid Arthritis" (Ann Intern Med 79:800-806, 1973) is interesting; however, it would be helpful to clarify some points.
1. In the supine position of the patient, a small pericardial effusion may be missed by echocardiography. In the semirecumbent position, which allows the pericardial fluid to accumulate toward the most dependent part of the pericardial sac, that is, the apical region of the heart, an ultrasound beam directed toward the apex may detect even a small effusion (1).
2. In our experience the echocardiographic criterion for the diagnosis of thickened pericardium is unreliable.
A. S. ABBASI. Heart in Rheumatoid Arthritis. Ann Intern Med. 1974;80:779–780. doi: 10.7326/0003-4819-80-6-779_2
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Published: Ann Intern Med. 1974;80(6):779-780.
Cardiology, Rheumatoid Arthritis, Rheumatology.
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