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    Autoimmune myocarditis in systemic sclerosis: an unusual form of scleroderma heart disease presentation.
    ESC Heart Fail 2017 Aug 22;4(3):365-370. Epub 2017 Apr 22.
    Coimbra Hospital and University Center, Cardiology Department, Coimbra, Portugal.
    Primary cardiac involvement in systemic sclerosis is common, often subclinical, and is associated with significant mortality. We report the case of a patient who developed autoimmune myocarditis at an early stage of systemic sclerosis, who completely recovered from cardiac dysfunction under optimal medical therapy for heart failure and immunosuppression. This challenging case aims at increasing awareness around the fact that the heart is a target organ of scleroderma disease. It also highlights the importance of screening and early diagnosis of cardiac involvement, because a timely treatment may impact the quality of life of these patients and improve their prognosis.

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    Recognizing and treating myocarditis in recent-onset systemic sclerosis heart disease: potential utility of immunosuppressive therapy in cardiac damage progression.
    Semin Arthritis Rheum 2014 Feb 6;43(4):526-35. Epub 2013 Aug 6.
    Division of Rheumatology, Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, CIC-Via Moscati 31, Rome 00168, Italy. Electronic address:
    Objectives: Scleroderma heart disease is a major risk of death in systemic sclerosis (SSc). Mechanisms underlying myocardial damage are still unclear. We performed an extensive study of SSc patients with recent-onset symptoms for heart disease and examined the efficacy of immunosuppressive therapy. Read More
    [Heart involvement in systemic sclerosis: analysis of four cases].
    Ann Acad Med Stetin 2012 ;58(1):33-9; discussion 39
    Katedra i Klinika Reumatologii i Układowych Chorób Tkanki Łacznej Uniwersytetu Medycznego w Lublinie, ul. K. Jaczewskiego 8, 20-950 Lublin.
    Introduction: Systemic sclerosis (SSc) is an autoimmune disease characterized by multisystem involvement. Heart involvement occurs in 80-100% of cases and represents one of the more common risk factors of death. Myocardial fibrosis and vascular microangiopathy lead to arrhythmias and impaired contractility with secondary left and right heart failure. Read More
    Acute myocarditis in fulminant systemic sclerosis.
    Chest 1992 Mar;101(3):872-4
    Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
    Myositis and myocarditis have been reported in progressive systemic sclerosis, and these patients have had favorable therapeutic responses to intravenous pulse methylprednisolone. Thus far, premortem biopsy documentation of myocarditis and myocardial fibrosis has not been reported in such patients. We report the case of a patient with subacute congestive heart failure six months after she developed Raynaud's phenomenon. Read More
    Systemic sclerosis and the heart.
    Rheum Dis Clin North Am 2014 Feb 7;40(1):87-102. Epub 2013 Nov 7.
    Division of Cardiology, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
    Heart disease, either clinically apparent or silent, is a frequent complication of systemic sclerosis (SSc, scleroderma) and may affect both patients with diffuse cutaneous and limited cutaneous SSc. The availability of more sensitive modalities has led to an increased awareness of scleroderma heart disease, which often involves the pericardium, myocardium, and cardiac conduction system. This awareness of cardiac involvement requires attention and interventions led by internists, cardiologists, and rheumatologists. Read More