Cardiac (Heart) Involvement in Systemic Sclerosis (Scleroderma)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview and Video
Correlation with Other Diseases
Systemic Scleroderma
Personal Stories

Overview and Video

Scleroderma Heart Involvement Video
Video: Scleroderma Heart Involvement

Presented by Amanda Thorpe
*More Sclero Videos*

The systemic forms of scleroderma can cause cardiac (heart) problems. One of the earliest symptoms reported by diffuse systemic scleroderma patients is heart irregularities. Systemic scleroderma can cause arrhythmias, pericardial effusion, and heart failure.

Formation of scar tissue in the heart and lungs has recently been recognized as a general pattern probably contributing to overall fatigue. It is very important for people with diffuse scleroderma to see a listed scleroderma expert and to report any heart-related symptoms if or when they arise. (Also see What is Scleroderma? and Types of Scleroderma, and Scleroderma Experts)

Progress in Understanding, Diagnosing, and Managing Cardiac Complications of Systemic Sclerosis. Recent application of novel cardiac detection strategies is providing increased insight into the breadth and pathogenesis of cardiac complications of scleroderma. PubMed, Curr Rheumatol Rep, 2019 Dec 7;21(12):68.

Keeping feelings bottled up could put women at risk of stroke: Study Women who tend to keep quiet about their feelings may be at risk for a stroke and other cardiovascular risks, according to presentation being made at the annual meeting of The North American Menopause Society. GMA Wellness, 09/26/2019.

8 Science-Backed Ways to Prevent Heart Attacks, According to New Guidelines. Experts have issued a new set of guidelines on the best ways to prevent first heart attacks, strokes and heart failure – and for the first time, they focus squarely on the patient. Time Healthland, 03/18/2019.

Workplace bullying and violence tied to higher risk of heart problems. People who are bullied or exposed to violence on the job may be more likely to develop cardiovascular disease than individuals who don’t deal with these challenges at work, a European study suggests. Reuters Health, 11/19/2018.

Poverty tied to worse heart health among U.S. teens. Adolescents from low–income families are more likely than their affluent peers to have risk factors for cardiovascular disease, a U.S. study suggests. Reuters Health, 10/17/2018.

Tooth loss in middle age linked to heart disease. Losing two or more natural teeth in middle age may signal an increased risk for coronary heart disease, a U.S. study suggests. Reuters Health, 04/18/2018. (Also see Periodontal Disease)

Cardiac (Heart) Symptoms

Cardiac (Heart) Symptoms. Common symptoms of heart failure include breathing difficulties, fatigue and exercise intolerance, and coughing. ISN.

Heart Symptoms in Women
Chest Pain
Common Symptoms of Heart Failure
Fainting (Syncope)

Correlation Between Cardiac and Other Diseases

Case Report: Severe biventricular thrombosis in eosinophilic granulomatosis with polyangiitis (EGPA). Cardiac involvement in EGPA, a rare cause of heart failure, can manifest as severe biventricular thrombosis and severe tricuspid regurgitation, resulting in heart failure with preserved ejection fraction. PubMed, Eur Heart J Case Rep. (Also see Granulomatosis with Polyangiitis)

Number of potentially fatal heart attacks drops by roughly 20 per cent after the clocks go back, study shows. A study of 460,000 Britons found that even those without family history of heart disease dramatically increased their risk of a heart attack by sacrificing sleep. Mail Online, 10/26/2019.

Effects of autonomic dysfunction (AD) on exercise tolerance in systemic sclerosis (SSc) patients without clinical and instrumental evidence of cardiac and pulmonary involvement. In SSc patients without cardiopulmonary involvement AD is associated with better exercise tolerance and cardiac function during physical effort. PubMed, Clin Exp Rheumatol, 05/04/2018. (Also see Brain Involvement)

Nocturia in Patients With Sleep-Disordered Breathing (SDB) and Cardiovascular Disease (CVD). Continuous positive airway pressure has the potential to reduce nocturia and risk factors for SDB, which may be beneficial in older men with CVD and obstructive sleep apnea. PubMed, Circ J. (Also see Sleep Apnea)

Myopathies related to systemic sclerosis: a case-control study of associated clinical and immunological features. Heart monitoring of SSc patients with myopathy should be undertaken regularly because of the association of myocardial and skeletal myopathies in such patients. PubMed, Scand J Rheumatol. (Also see Myopathies)

Antiphospholipid Syndrome (APS) and Heart Disease. ISN.

Systemic Scleroderma Heart Involvement

Systemic Scleroderma Cardiac (Heart) Involvement. The systemic forms of scleroderma can cause cardiac (heart) problems. One of the earliest symptoms reported by diffuse systemic scleroderma patients is heart irregularities. ISN.

Aortic Stiffness
Asymptomatic Pericardial
Cardiac Remodeling
Carotid Artery Disease
Left Ventricle
Lipoprotein[a], Thrombotic
Mitral/Tricuspid Valve
Myocardial Ischemia
Right Ventricle
Stroke and TIA

Vascular Disease and Systemic Scleroderma. The vascular system is our circulatory system. It consists of all the vessels that carry blood and lymph through the body, to and from organs. Vessels include arteries, veins, and capillaries. Any condition that affects the vascular system, all of in part, is considered a vascular disease. ISN.

Vascular in Scleroderma
Types in Scleroderma
In Other CTDs
Personal Stories
Related Information

Complications with Systemic Scleroderma Heart Involvement

Complications with Systemic Scleroderma Cardiac (Heart) Involvement include atrioventricular heart block, cardiogenic shock, myocardial infarction, and skeletal myopathy. ISN.

Aortic Valve Insufficiency
Arterial Stiffness
Atrioventricular Heart Block
Cardiogenic Shock
Cardiac Tamponade
Diastolic Dysfunction
Macrovascular Disease
Myocardial Infarction
Skeletal Myopathy


Diagnosis of Systemic Scleroderma Cardiac (Heart) Involvement. It is common for patients with systemic scleroderma to develop heart involvement even without any overt cardiac symptoms, so mandatory assessment of systemic scleroderma heart involvement requires a thorough baseline screening and follow-up monitoring. ISN.

CT Scans
--ECHO (General)
--Tissue Doppler
Heart Rate
Holter Monitoring


Treatments for Systemic Scleroderma Cardiac (Heart) Involvement include Bosentan, and calcium channel blockers such as nicardipine (Cardene) and nifedipine (Adalat, Procardia). ISN.

Beta Blockers
Bosentan, Tracleer
Combination Therapy
Calcium Channel Blockers
Nicardipine, Nifedipine
Coronary Artery Bypass
Dietary Approaches
Pericarditis Treatments


Research about Systemic Scleroderma Heart Involvement. Topics include antibodies, autoimmunity, case studies, and causes of scleroderma heart involvement. ISN.

Autoimmunity and Heart Disease
Causes of Heart Disease

Personal Stories: Cardiac (Heart) Involvement

Patient and Caregiver Stories: Cardiac (Heart) Involvement. ISN.

Anastasia: Surviving Granddaughter of a Diffuse Scleroderma Patient Traveling to a different hospital finally we heard scleroderma…

Angela S: Overlap Syndrome I am twenty-five years old and I was diagnosed with polymyositis and scleroderma, rheumatoid arthritis, mitral valve prolapse, a heart murmur, and pericarditis…

Angiola: Progressive Systemic Scleroderma (Italy) I would very much like to find other people that find themselves in a similar situation…

Read more stories…

Go to Complications

SCLERO.ORG is the world's leading nonprofit for trustworthy research, support, education and awareness for scleroderma and related illnesses. We are a 501(c)(3) U.S.-based public charitable foundation, established in 2002. Meet Our Team. Donations may also be mailed to:

International Scleroderma Network (ISN)
7455 France Ave So #266
Edina, MN 55435-4702 USA
Email [email protected]. Disclaimer. Privacy Policy.