Limited Utility of Screening Electrocardiograms in Systemic Sclerosis: Data from the Canadian Scleroderma Research
Sophie Wojcik1, Christos Galatas1, Alaa Dekis1
1McGill University, Montreal, Quebec, Canada.
ACR Open Rheumatology
|September 17, 2025
Summary
Electrocardiograms (EKGs) do not show more conduction abnormalities in systemic sclerosis (SSc) patients compared to controls. However, EKGs may reveal right heart stress and potential myocardial damage in SSc, warranting further investigation.
Area of Science:
- Cardiology
- Rheumatology
- Medical Diagnostics
Background:
- Systemic sclerosis (SSc) is associated with cardiac complications.
- Electrocardiograms (EKGs) have been proposed as a screening tool for cardiac disease in SSc.
Purpose of the Study:
- To compare the prevalence of EKG abnormalities in SSc patients versus controls.
- To evaluate the utility of EKGs as a screening tool for cardiac disease in SSc.
Main Methods:
- Retrospective comparison of EKGs from 833 SSc patients and 832 age- and gender-matched controls.
- Standardized EKG interpretation by two cardiologists.
- Statistical analysis using t-tests, chi-squared tests, and Fisher exact tests.
Main Results:
- No significant difference in conduction and rhythm abnormalities between SSc patients and controls.
- Increased prevalence of possible right atrial enlargement, right axis deviation, left atrial enlargement, poor R progression, and non-specific T wave abnormalities in SSc patients.
- These findings suggest potential right heart stress and myocardial damage in SSc.
Conclusions:
- Conduction abnormalities are not more prevalent in SSc patients than controls.
- EKG findings like right heart stress and poor R wave progression may indicate underlying structural heart disease in SSc.
- EKGs are not currently recommended as a screening tool for cardiac abnormalities in SSc pending further research.
Related Concept Videos
01:29Electrocardiogram
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...