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Case 13

History

  • 43 year old male
  • Increasing dyspnea

Findings




Diagnosis

Systemic Sclerosis: Pericarditis, Constrictive physiology Papillary infarct, Atypical scarring, Tricuspid Regurgitation.
  • Direct: myocardial fibrosis, pericardial disease, coronary artery disease (like raynauds phenomenon?)
  • Indirect: Pulmonary arterial hypertension +/- interstitial lung disease, renal failure
  • MRI: Myocardial scarring, Wall motion abnormalities, Pericardial thickening, effusion, enhancement
  • Pulmonary arterial hypertension: Big rt sided chambers, pulmonary arteries enlarge. Pulmonary oedema. Tricuspid regurgitation +/- pulmonary regurgitation. Flattening of interatrial septum in diastole (increased volume) and systole (increased pressure)

Treatment

  • Treat syastemic sclerosis (immune modifying agents). Also treat infatct.