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Diagnosis of Systemic Scleroderma Heart Involvement

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
CT Scans
--ECHO (General)
--Tissue Doppler
Heart Rate
Holter Monitoring


Screening for heart involvement is mandatory for all systemic scleroderma patients.

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. Diagnostic tests for scleroderma heart involvement may include electrocardiograms, echocardiography, Holter monitoring, CT scans, and MRI's. (Also see What is Scleroderma?, Types of Scleroderma, Symptoms of Scleroderma and Overview of Cardiac Involvement)

Diagnostic tests for cardiac problems include Electrocardiogram (ECG) and Holter Monitor. (See Medical Tests)

CT Scans

Usefulness of technetium-99 m sestamibi myocardial perfusion SPECT in detection of cardiovascular involvement in patients with systemic lupus erythematosus or systemic sclerosis. Tc-99m sestamibi SPECT is a useful noninvasive imaging modality to detect cardiac involvement in symptomatic or asymptomatic SLE or SS patients. Lin CC. (PubMed) Int J Cardiol. 92(2-3):157-61.

Echocardiography (ECHO)

ECHO (General) Tissue Doppler Analysis

ECHO (General)

Handheld Echocardiography: Current State and Future Perspectives. This review summarizes the existing literature on the use of handheld echocardiography in conducting focused cardiac examinations and future perspectives in the care of the cardiovascular patient. PubMed, Circulation, 2017 Nov 28;136(22):2178-2188.

Clinical determinants of elevated systolic pulmonary artery pressure measured by transthoracic Doppler echocardiography in early systemic sclerosis (SSc). Our findings emphasize the need to consider right heart catheterisation in selected early SSc patients with PH suspicion, to clearly determine the cause of pulmonary hypertension. PubMed, Clin Exp Rheumatol, 2017 Sep-Oct;35 Suppl 106(4):114-121.

Tissue Doppler Analysis ECHO

Right ventricular systolic dysfunction often precedes the onset of symptoms in systemic sclerosis, however it is not apparent by Tissue Doppler, but can be detected by Strain.

Tissue Doppler ECHO. This test is used to look at how blood flows through the heart chambers, heart valves, and blood vessels. WebMD.

Electrocardiogram (ECG or EKG)

Electrocardiogram. An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. WebMD.

Heart rate turbulence assessment in systemic sclerosis: the role for the detection of cardiac autonomic nervous system dysfunction. HRT, like HRV assessment, indicates a frequent impairment of the cardiac autonomic nervous system in SSc patients, irrespective of the SSc type. Rheumatology.

Heart Rate

Problem with Heart Rate can be determined with ECG/EKGs and Holter Monitors.

Panic attacks. Panic attacks were once dismissed as nerves or stress, but they're now recognized as a real medical condition. Signs and symptoms may include rapid heart rate, sweating, trembling, shortness of breath and hyperventilation, chills, hot flashes, nausea, abdominal cramping, chest pain, headache, dizziness, faintness, tightness in your throat, trouble swallowing, a sense of impending death. Other health problems— such as an impending heart attack, an overactive thyroid gland (hyperthyroidism) or drug withdrawal— can cause similar signs and symptoms. Mayo Clinic. (Also see Lung Involvement, Heart Involvement and Thyroid Disease)


Relationship Between Ventricular Arrhythmias, Conduction Disorders, and Myocardial Fibrosis in Patients With Systemic Sclerosis. Delayed–enhancement magnetic resonance imaging can identify myocardial fibrosis in a high percentage of scleroderma patients. PubMed, J Clin Rheumatol, 12/01/2017.

Cardiac magnetic resonance (CMR) in systemic sclerosis patients with cardiac symptoms. Myocardial involvement in systemic sclerosis can be assumed by the presence of multiple pathologic MRI findings and CMR seems to be a valuable tool to identify and assess the presence of cardiac involvement. PubMed, Eur Rev Med Pharmacol Sci, 2017 Nov;21(21):4797-4803.

Holter Monitoring

Scleroderma Heart Disease Deaths Might Be Prevented with Heart Monitor. Magnetic resonance imaging (MRI) confirmed rhythm changes in both the upper and lower chambers of the heart, as well as an abnormally fast heart rate and complete heart block which was shown on the heart monitors. Scleroderma News.


Scintigraphy may help detect scleroderma cardiac involvement, even before there are heart symptoms.

Definition of Scintigraphy. A diagnostic test that uses radioisotopes. MedicineNet.

Go to Research for Cardiac Involvement

SCLERO.ORG was the world's leading nonprofit for trustworthy research, support, education and awareness for scleroderma and related illnesses from 1998 to 2021. It was a grassroots movement from the original Scleroderma from A to Z web site, which was founded by Shelley Ensz. We were a 501(c)(3) U.S.-based public charitable foundation. We closed this web site and our nonprofit agency in April 2021.

International Scleroderma Network (ISN)