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Treatments for Systemic Scleroderma Heart Involvement

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Beta Blockers
Bosentan, Tracleer
Combination Therapy
Calcium Channel Blockers
Nicardipine, Nifedipine
Coronary Artery Bypass
Dietary Approaches
Pericarditis Treatments

Overview of Treatments for Systemic Scleroderma Heart Involvement

Treatments for systemic scleroderma heart involvement include Bosentan (Tracleer), and calcium channel blockers such as nicardipine (Cardene) and nifedipine (Adalat, Procardia).

For severe cardiac involvement of children with diffuse scleroderma and myositis, a combination therapy of corticosteroids, methotrexate, and cyclosporine may be used. (Also see What is Scleroderma?, Types of Scleroderma, Symptoms of Scleroderma, and Overview of Cardiac Involvement)

ACE Inhibitors: Warning for Systemic Scleroderma

Warning for use of ACE inhibitors scleroderma patients

Cautious ACE Inhibitor Use Needed in Scleroderma. This study suggests that ACE inhibitors should be used with great caution in patients with scleroderma, particularly early in disease when the risk of renal crisis is greatest. MedPageToday. (Also see Kidney Involvement, Medication Warnings, and Hypertension)

Ace inhibitors in the U.S. are generic and brand names such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril) moexipril (Univasc), and perindopril(Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik). MedicineNet.

Beta Blockers

Scleroderma can cause increased heartrates and arrhythmias. Beta Blockers may be prescribed to treat these symptoms. Beta Blockers include acebutolol, atenolol, bisoprolol, metoprol, nadolol, and timolol.

Persons with Raynaud's should be aware that beta blockers can worsen their Raynaud's symptoms.

Bosentan, Tracleer

Bosentan is also known as "Tracleer". It treats many of the symptoms of systemic sclerosis. See Bosentan/Tracleer.

Vasodilators and low-dose acetylsalicylic acid (ASA) are associated with a lower incidence of distinct primary myocardial disease manifestations in systemic sclerosis: results of the DeSScipher inception cohort study. The present study might suggest a preventative effect on the occurrence of distinct myocardial manifestations by vasodilator therapy and low-dose ASA. PubMed, Ann Rheum Dis, 08/07/2019.

Calcium Channel Blockers

Nicardipine (Cardene) Nifedepine (Adalat, Procardia)

Nicardipine (Cardene)

Nicardipine is a calcium channel blocker type of blood pressure medication, which is also known by the brand name Cardene. MedicineNet.

Nifedipine (Adalat, Procardia)

Nifedipine is a calcium channel blocker type of blood pressure medication, which is also known by the brand names of Adalat and Procardia. MedicineNet.

Evaluation of nifedipine efficacy on myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis. Fourteen days of treatment with nifedipine simultaneously improves myocardial perfusion and function, as evaluated by highly sensitive and quantitative methods. PubMed, Ann Rheum Dis.

Combination: Corticosteroids, Methotrexate, Cyclosporine

A case of systemic sclerosis and sjogren's syndrome with cardiac tamponade due to steroid-responsive pericarditis. Pericarditis due to SSc has been reported unresponsive to steroid therapy, but several cases of steroid responsive pericarditis due to SSc or SjS have been reported. PubMed, Arerugi.

(Expired Article) Severe Cardiac Involvement in Children with Systemic Sclerosis and Myositis. Children with diffuse scleroderma and features of polymyositis are prone to develop severe cardiomyopathy. Combination therapy of corticosteroids, MTX, and cyclosporine seems to be active on muscle, skin, and lung involvement but does not impair progression of esophageal or myocardial dysfunction. The Journal of Rheumatology VOLUME 29: NO. 8 AUGUST [2002]. (Also see Diffuse Scleroderma, Juvenile Scleroderma, and Polymyositis)

Coronary Artery Bypass Grafting

Coronary artery bypass surgery creates a new path for blood to flow to the heart. The surgeon takes a healthy piece of vein from the leg or artery from the chest or wrist. Then the surgeon attaches it to the coronary artery, just above and below the narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more than one bypass. MedlinePlus.

Many older U.S. adults don't get needed cardiac rehab after a heart attack Only about one in four patients on Medicare receive cardiac rehabilitation recommended to help them recover from events like a heart attack or coronary bypass surgery, a U.S. study suggests. Reuters Health, 01/17/2020.

Dietary Approaches for Heart Health

Seek medical advice for dietary approaches to heart disease. Be sure to also list all of the vitamin and herbal supplements that you are taking, or thinking about taking, with your doctor since some may interact with medications or worsen symptoms of heart disease. (Also see:Alternative Therapies)

Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health. PubMed, Methodist Debakey Cardiovasc J, Jul-Sep 2019;15(3):207-213. (Also see Vitamin D Deficiency and Supplement Guide)

Pericarditis Treatments

Pericarditis: NSAIDS, Corticosteroids

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