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[Cardiac tamponade preceding skin involvement in progressive systemic sclerosis]
G Peronato1, P De Sandre, M Podswiadek
1U.O. di Medicina 2, Ospedale S. Bortolo, Vicenza. peronato@libero.it
Reumatismo
|October 31, 2002
Summary
Systemic Sclerosis (SSc) rarely presents clinically as pericarditis, but can cause large pericardial effusions. This case highlights pericardial tamponade preceding skin hardening in SSc.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Pericardial involvement is common in Systemic Sclerosis (SSc) but clinically underdiagnosed.
- Pericarditis with effusion or tamponade is a rare clinical manifestation of SSc.
Observation:
- A 71-year-old female presented with cardiac tamponade due to a large pericardial effusion requiring drainage.
- The patient had a 25-year history of Raynaud's phenomenon.
- Cutaneous manifestations of SSc (skin hardening) appeared six weeks after hospital discharge.
Findings:
- This case represents pericardial tamponade preceding the diagnosis of SSc.
- Only two other cases in the literature describe pericardial effusion preceding cutaneous SSc involvement.
Implications:
- Pericardial effusion and tamponade can be an early, presenting sign of Systemic Sclerosis.
- Increased clinical suspicion for SSc is warranted in patients with unexplained pericardial effusion, especially those with Raynaud's phenomenon.