200 in-patients with rheumatoid arthritis (RA) were examined with regard to the diagnostic criteria for early recognition of rheumatoid heart involvement. 75 patients showed some evidence (37.5%). The criteria are: subjectively, reduced general state, feeling of oppression, disproportional tachycardia and dyspnea: objectively, changes in the electrocardiogram (tachycardia, T-inversions sometimes resembling to infarct pictures, disturbances of repolarization, extrasystoles and AV blocks). The severity of the change may alter rapidly. Severe myocarditides may manifest as heart failure and dilatation of rapid onset. For prognostic and therapeutic reasons the recognition of a heart involvement, despite these often minimal appearances, is important. It is remarkable that there was no correlation between the activity of rheumatoid process, the titre of rheumatoid factor, and the degree of heart involvement. Age and age of onset, duration of disease and sex also showed no correlation with rheumatoid heart involvement.

Age Factors↗

PubMedDate not supplied

[Significance of various clinical pictures falling under the general term "rheumatism" for social medicine].

Statistical reports of the "Bundesversicherungsanstalt für Angestellte" and from an affiliated rheumatological rehabilitation clinic show that within the general term of "rheumatism" inflammatory rheumatic diseases are only a few per cents. Myalgic syndromes of the vertebral column without obvious changes of the skeleton rank first. They are followed by degenerative diseases of the vertebral column and peripheral joints. While the number of treatment courses of cardiovascular disorders for men and women (male predominance) remained relatively constant from 1968-1974 and in 50% of the cases lead to pensioning-off, treatment courses of bone and joint diseases have clearly increased with a female predominance; pensioning-off is necessary only in a few cases. There is no correlation between morbidity and number of treatment courses; the importance of economical and social factors for the therapeutic regimen is pointed out. Rehabilitation clinics of the pension-paying institutions offer optimal possibilities of a long term treatment of rheumatic diseases, as single or repeat treatment. The activities of a league against rheumatism should concentrate on the clinically and sociomedically most severe joint diseases.

Germany, West↗