Magnetic Resonance Imaging for the Detection of Myocardial Fibrosis in Scleroderma

Abstract

A 65-year-old woman with diffuse scleroderma presented with increasing dyspnea on exertion, fatigue, and approximately a six-week history of palpitations. She had a history of scleroderma-related pulmonary fibrosis, which was clinically stable, but no ischemic heart disease or other cardiomyopathy. Physical examination revealed pedal edema and neck-vein distention, consistent with right heart failure. Electrocardiography showed frequent atrial and ventricular premature beats, right bundle-branch block, and left anterior fascicular block. There was evidence of biventricular diastolic dysfunction on two-dimensional echocardiography. Cardiac enzymes were within the normal range on repeated measurements.