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[Cardiovascular manifestations in systemic scleroderma]
Insights
Systemic scleroderma frequently causes hidden heart disease. Routine cardiovascular screening is crucial for early detection and management in these patients.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Context:
- Systemic scleroderma is an autoimmune disease affecting connective tissues.
- Cardiovascular involvement is a significant contributor to morbidity and mortality in scleroderma patients.
- Latent cardiac disease is common in systemic scleroderma.
Purpose:
- To investigate the prevalence and types of cardiovascular manifestations in patients with systemic scleroderma.
- To determine the correlation between cardiovascular disease and patient factors like age and treatment.
Summary:
- A prospective study evaluated 29 systemic scleroderma patients with comprehensive cardiovascular assessments.
- Heart disease was found in 48.3% of patients, with myocardial disease being most prevalent (37.9%).
- Hypertension, Raynaud syndrome, and rhythm/conduction disorders were also observed, with correlations to age and treatment status.
Impact:
- Highlights the high frequency of often-undetected cardiac issues in systemic scleroderma.
- Underscores the necessity of routine cardiovascular evaluations for all scleroderma patients.
- Informs clinical practice regarding proactive cardiac monitoring in this population.
Objectives:
Patients with systemic scleroderma often have latent heart disease which could play an important role in morbidity and mortality. We therefore conducted a prospective study of cardiovascular manifestations in patients with systemic scleroderma.
Patients And Methods:
A prospective cross-sectional study included 29 patients with systemic scleroderma who underwent a complete cardiovascular work-up including physical examination, electrocardiogram, chest x-ray and Doppler-echocardiogram from July 1993 to February 1996.
Results:
Hypertension was observed in 6 patients (20.7%) and was positively correlated with age (p = 0.007). Raynaud syndrome was also found in 6 patients (20.6%). Heart disease was observed in 14 patients (48.3%) and was positively correlated with age and lack of treatment for scleroderma (p = 0.008). Myocardial disease was the most frequent (11 patients, 37.9%), followed by pericardial disease and valve disease (4 cases each, 13.8%). Rhythm and conduction disorders were found in 2 (6.9%) and 8 (27.6%) of the patients.
Conclusion:
Cardiovascular manifestations are frequent but often latent in patients with systemic scleroderma. This finding emphasizes the importance of routine cardiovascular work-up in all patients with scleroderma.