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Large Left Ventricular Aneurysm and Multifocal Myocardial Involvement in a Patient With Systemic Sclerosis

Luca Olivotti1, Deborah Cosmi1, Annamaria Nicolino1

  • 1Cardiovascular Department, Santa Corona Hospital, Pietra Ligure (SV), Italy.

The Canadian Journal of Cardiology
|July 3, 2017
PubMed

Insights

Systemic sclerosis can cause severe cardiac issues, including fibrotic aneurysms and new lesions. Cardiac magnetic resonance imaging (MRI) is crucial for evaluating myocardial involvement in these patients.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Rheumatology

Background:

  • Systemic sclerosis is an autoimmune disease that can affect multiple organs, including the heart.
  • Myocardial involvement in systemic sclerosis can lead to various cardiac complications.
  • Electrocardiographic abnormalities and chest pain are common presenting symptoms.

Observation:

  • A 43-year-old male with systemic sclerosis presented with chest pain and negative T waves.
  • Echocardiography revealed a left ventricular apical accessory chamber.
  • Coronary arteries were normal, but cardiac MRI identified a fibrotic aneurysm and septal late enhancement.

Findings:

  • Surgical removal of the aneurysm was performed.
  • An 8-month follow-up cardiac MRI showed a new anterior wall nodular lesion.
  • This lesion caused a localized wall motion abnormality, indicating progressive myocardial disease.

Implications:

  • Systemic sclerosis can lead to severe and progressive myocardial damage.
  • Cardiac MRI is essential for detecting and monitoring cardiac involvement in systemic sclerosis.
  • Early detection and management of cardiac lesions are vital for patient outcomes.

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