Complete Heart Block in Systemic Sclerosis with Characterization on Cardiac MRI

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis affecting multiple organs, including the heart.
• Cardiac involvement in SSc significantly increases morbidity and mortality, with potential impact on all cardiac structures.
• While cardiac manifestations are known, involvement of the conduction system is less common.

Observation:

• A rare case of SSc presenting with third-degree atrioventricular block (AVB) is described.
• Cardiac magnetic resonance imaging (CMR) was utilized as a key diagnostic and prognostic tool in this patient.
• This represents the first reported use of CMR for diagnosing AVB in the context of SSc.

Findings:

• CMR successfully identified the extent of cardiac involvement and provided prognostic information in a patient with SSc-induced AVB.
• The study highlights the potential of CMR in evaluating conduction system abnormalities in SSc.

Implications:

• The findings suggest CMR may aid in earlier diagnosis and risk stratification for cardiac complications in SSc.
• Further research is needed to determine if CMR-guided management leads to improved patient outcomes or timely transplant referral.
• This case underscores the importance of considering cardiac involvement, including conduction abnormalities, in patients with systemic sclerosis.