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Complete Atrioventricular (AV) Block as a Cardiac Complication of Rheumatoid Arthritis: A Rare Case Report

ACTA MEDICA INDONESIANA · Vol. 57 No. 3 (2025)

ISSN
2338-2732, 0125-9326
Terbit
2025-10-03
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Atrioventricular block (AVB) is a rare complication of rheumatoid arthritis (RA). Complete AVB in people with RA significantly increases cardiovascular morbidity and doubles the mortality risk. We report on a 48-year-old woman presenting with dyspnea and peripheral edema, with symptoms of polyarthritis for 3 years. Physical findings included bradycardia, bilateral rales, and finger deformities consistent with RA. Electrocardiography featured complete AVB, and a thoracic computed tomography scan showed a mosaic appearance with fibrosis, bronchiectasis, and partial atelectasis of the lungs. Further tests showed elevated levels of C-reactive protein, rheumatoid factor, and several inflammatory cytokines. Transient followed by permanent pacemaker placement was performed along with pharmacological treatments, including intravenous (IV) methylprednisolone pulse therapy and IV tocilizumab. Cardiac involvement in RA usually takes the form of pericardial effusion, heart failure, myocarditis, and coronary artery disease. Complete AVB is a rare but important extra-articular involvement in RA that warrants early recognition and treatment with a pacemaker, anti-inflammatory drugs, and disease-modifying antirheumatic drugs.

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">Complete Atrioventricular (AV) Block as a Cardiac Complication of Rheumatoid Arthritis: A Rare Case Report</dc:title>
	<dc:creator>Johan, Christian</dc:creator>
	<dc:creator>Anfasa, Fatih</dc:creator>
	<dc:creator>Susilo, Adityo</dc:creator>
	<dc:creator>Damanik, Johanda</dc:creator>
	<dc:creator>Hidayat, Rudy</dc:creator>
	<dc:creator>Sumariyono, Sumariyono</dc:creator>
	<dc:creator>Anggoro Kusumo Wibowo, RM. Suryo</dc:creator>
	<dc:creator>Ariane, Anna</dc:creator>
	<dc:creator>Parlindungan, Faisal</dc:creator>
	<dc:creator>Priandani Araminta, Abirianty</dc:creator>
	<dc:subject xml:lang="en-US">cardiac complication</dc:subject>
	<dc:subject xml:lang="en-US">complete atrioventricular (AV) block</dc:subject>
	<dc:subject xml:lang="en-US">rheumatoid arthritis</dc:subject>
	<dc:subject xml:lang="en-US">rheumatology</dc:subject>
	<dc:description xml:lang="en-US">Atrioventricular block (AVB) is a rare complication of rheumatoid arthritis (RA). Complete AVB in people with RA significantly increases cardiovascular morbidity and doubles the mortality risk. We report on a 48-year-old woman presenting with dyspnea and peripheral edema, with symptoms of polyarthritis for 3 years. Physical findings included bradycardia, bilateral rales, and finger deformities consistent with RA. Electrocardiography featured complete AVB, and a thoracic computed tomography scan showed a mosaic appearance with fibrosis, bronchiectasis, and partial atelectasis of the lungs. Further tests showed elevated levels of C-reactive protein, rheumatoid factor, and several inflammatory cytokines. Transient followed by permanent pacemaker placement was performed along with pharmacological treatments, including intravenous (IV) methylprednisolone pulse therapy and IV tocilizumab. Cardiac involvement in RA usually takes the form of pericardial effusion, heart failure, myocarditis, and coronary artery disease. Complete AVB is a rare but important extra-articular involvement in RA that warrants early recognition and treatment with a pacemaker, anti-inflammatory drugs, and disease-modifying antirheumatic drugs.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-10-03</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Case report</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2728</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 3 (2025): Acta Medica Indonesiana; 368</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2728/816</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Christian Johan, Fatih Anfasa, Adityo Susilo, Johanda Damanik, Rudy Hidayat, Sumariyono Sumariyono, RM. Suryo Anggoro Kusumo Wibowo, Anna Ariane, Faisal Parlindungan, Abirianty Priandani Araminta</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>