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Cardiac involvement in progressive systemic sclerosis.

S Todesco, A Gatta, S Glorioso

    Acta Cardiologica
    |January 1, 1979
    PubMed
    Summary
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    Progressive systemic sclerosis (PSS) can cause myocardial necrosis without infarction symptoms. Electrocardiograms and hemodynamic studies in PSS patients revealed heart muscle damage, suggesting PSS-related cardiac disease.

    Area of Science:

    • Cardiology
    • Rheumatology
    • Pathology

    Background:

    • Progressive systemic sclerosis (PSS) is a multisystem autoimmune disease.
    • Cardiac involvement is a significant cause of morbidity and mortality in PSS.
    • Subtle or atypical cardiac manifestations can complicate diagnosis.

    Observation:

    • A case of PSS presenting with electrocardiographic and vectorcardiographic evidence of myocardial necrosis, but lacking typical myocardial infarction symptoms.
    • Coronary angiography revealed no obstructive coronary artery disease.
    • Cineventriculography showed a hypokinetic, enlarged left ventricle.

    Findings:

    • Analysis of 43 PSS patients revealed electrocardiographic signs of myocardial necrosis in 5 individuals, none with clinical myocardial infarction.

    Related Experiment Videos

  • Hemodynamic investigations in 13 PSS patients identified a dip-plateau pattern in the right ventricle pressure curve in 3 cases.
  • These findings suggest myocardial disease in PSS, distinct from ischemic heart disease.

    • Implications:

    • Electrocardiographic "necrosis" patterns in PSS may indicate underlying myocardial disease rather than acute infarction.
    • Hemodynamic restrictive findings and ventricular enlargement on ventriculography are potential indicators of cardiac involvement in PSS.
    • Early recognition of these cardiac manifestations is crucial for managing PSS patients and improving outcomes.