Cardiac involvement in progressive systemic sclerosis (P.S.S.) - an echocardiographic study

Echocardiography was used to determine the incidence and severity of cardiac lesions in 20 patients with progressive systemic sclerosis. Abnormal findings were recorded in 14 (70%) patients. These included pericardial effusion in five, increased left ventriculate posterior wall thickness in four with no systemic hypertension, decreased diastolic closure of anterior mitral leaflet in five, and abnormal septal features in four patients. Dilatation of aortic root was found in two patients and moderated thickening of the anterior mitral valve in one patient. Clinical evidence of scleroderma heart was found in one of the 20 patients. Abnormal ECG changes were found in 12 (60%) of the patients. These included LVH, simulating MI pattern, conduction disturbances and P wave changes. Echocardiography proved to be an important non-invasive diagnostic tool which decreases the discrepancy between the relatively few clinical findings and rich cardiac pathology. Furthermore, this study confirms the usefulness of the method in the evaluation of the 'asymptomatic' cardiac patient.