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May 1950

CARDIAC LESIONS IN RHEUMATOID ARTHRITIS: A Summary of Recent Developments and a Bedside Study of Patients and Controls

Author Affiliations


Arch Intern Med (Chic). 1950;85(5):751-764. doi:10.1001/archinte.1950.00230110026002

DURING the past century the clinical identities of rheumatic fever and the frequently encountered progressive form of articular rheumatism which is now designated "rheumatoid arthritis" have been established with a fair degree of certainty. However, the etiologic agents responsible for these two diseases remain unknown, and no specific tests have been devised to distinguish them.

In classic instances, the clinical and pathologic manifestations of the two diseases are strikingly different. Rheumatoid arthritis in its usual form is characterized by the progressive and chronic character of its articular lesions. Joints are visibly damaged in the early stages, and this damage is apt to increase with the passage of time. From a clinical point of view, the heart usually seems to be spared. Articular inflammation of patients with rheumatic fever, on the contrary, is fleeting and migratory. After acute attacks, joints appear normal. Cardiac complications are regularly encountered in rheumatic fever and