Assessment of heart involvement

Area of Science:

• Cardiology
• Rheumatology
• Pulmonology

Background:

• Cardiac involvement is common in systemic sclerosis (SSc), significantly influencing patient symptoms and disease outcomes.
• Symptoms like dyspnoea, fatigue, and palpitations can indicate underlying cardiac issues in SSc.
• Early detection and management of cardiac complications are crucial for improving SSc patient prognosis.

Purpose of the Study:

• To emphasize the mandatory nature of baseline cardiac screening and ongoing monitoring for all patients with systemic sclerosis.
• To outline the diagnostic procedures for evaluating cardiac function and detecting pulmonary hypertension in SSc.
• To highlight the importance of a comprehensive approach to cardiac assessment in SSc management.

Main Methods:

• Initial screening involves non-invasive ambulatory diagnostic procedures: clinical visit, electrocardiogram, chest X-ray, and Doppler-bidimensional echocardiogram.
• These methods assess rhythm/conduction disturbances, cardiac morphology/function, and screen for pulmonary hypertension (PH).
• Further investigations may include long-term ECG, exercise tests, cardiac MRI, nuclear imaging, and cardiac catheterization for PH confirmation.

Main Results:

• Non-invasive tests provide essential information on cardiac status and potential PH in SSc patients.
• A stepwise diagnostic approach allows for tailored cardiac evaluation based on initial findings.
• Comprehensive assessment aids in understanding the full spectrum of cardiac involvement in SSc.

Conclusions:

• Mandatory baseline cardiac screening and regular follow-up are essential for all systemic sclerosis patients.
• A combination of non-invasive and, when necessary, invasive diagnostic tools ensures thorough cardiac evaluation.
• Effective management of cardiac complications in SSc is vital for improving patient quality of life and prognosis.