What types of heart diseases occur with Systemic Sclerosis?
Myocardial, pericardial, or conduction system disease are all potential cardiac complications associated with SSc. Diastolic dysfunction is one of the more common cardiac manifestations of SSc and can lead to PH due to left heart disease. Cardiomyopathy associated with SSc can be difficult to distinguish from ischemic cardiomyopathy; cardiac MRI may be useful in this regard as patients with SSc-cardiomyopathy typically have evidence of an infiltrative or fibrotic process. SSc-cardiomyopathy may be more commonly seen in African–Americans, those with diffuse skin involvement and RNA polymerase III antibody positivity. Pericardial effusions are almost always asymptomatic, are associated with the presence of PH, and do not require specific intervention. Symptomatic, inflammatory pericarditis is rare and may be treated with nonsteroidal antiinflammatory drugs, low-dose corticosteroids, or colchicine. Cardiovascular disease including coronary artery disease is increased in SSc (hazard ratio 3.2). In general, cardiac disease in SSc is associated with a poor prognosis, accounting for 26% of all SSc-related deaths and 29% of non–SSc-related deaths.
