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Rapidly Progressive Cardiac Tamponade in Uncontrolled Rheumatoid Arthritis Complicated by Diabetic Ketoacidosis

Year: 2025

Type: article

Abstract: Rheumatoid arthritis (RA) can involve extra-articular organs, including the heart, with pericardial effusions being common but rarely progressing to cardiac tamponade. We report a 42-year-old female with uncontrolled RA, markedly elevated anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF), and type 2 diabetes mellitus, who presented with severe chest pain, shortness of breath, and diabetic ketoacidosis. Rapid accumulation of a large pericardial effusion led to cardiac tamponade, requiring emergency pericardial drainage during a peri-arrest state. Despite aggressive critical care, she developed hypoxic brain injury and multi-organ dysfunction, ultimately leading to death. This case highlights the importance of early recognition of cardiac involvement in RA, the potential severity of extra-articular manifestations even in the absence of active joint disease, and the need for prompt intervention in life-threatening complications.

Source: Cureus

DOI: 10.7759/cureus.96976

Authors: Turna Zaman, Rafid Mustafa, Sultana Jannatun Nahar, G K M Rashik Uzzaman, Cornelius Fernandez James

Institutions: United Lincolnshire Hospitals NHS Trust, University of Hull, Pilgrim Hospital

Language: English

Topic: Pericarditis and Cardiac Tamponade

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416263394