Hypertension and heart problems with systemic sclerosis

[tessa0825]

Thank you for this forum and for taking my questions...I was recently diagnosed with scleroderma after progressing medical conditions of the last two years...I had esophageal surgery at your facility last year for complications of reflux including barrett's esophagus with stricture and dysplasia (gastroplasty/fundoplication)...Prior to surgery I also had a cardiology evaluation in your heart center...I had been having alot of chest area pains and it was unsure if these were esophageal or coronary in nature...My dyastolic BP was very high and in addition to hyzaar and demadex that I have been on I was started on toprol XL 50mg daily....I also have PVCs but  was cleared for suregry...At that time I had not yet received the ss diagnosis..Since I have been diagnosed I have been reading up on this illness and it seems to have over whelmed me...In addition to the HBP meds mentioned I also take nexium (stll refluxing) twice daily, zelnorm twice daily, miralax twice daily, bentyl 4x daily, prednisone 3x daily, and weekly injections with MTX and enbrel...Last week I was hosp. for IVs of antibiotics as my WCC as been very high....I have been becoming very SOB and it sems to be getting worse...This had not been a problem until recently and i find I cant climb one flight of stairs without having to sit and concentrate on breathing....Im not overweight(140lbs) I have gained since prednisone from 115lb.. Could you please tell me what the implications for heart problems are with the scleroderma diagnosis and what things I need to watch for...Thank you so much

[CCF-M.D.-RCJ]

tessa0825,

Thanks for the post.

Q:"Could you please tell me what the implications for heart problems are with the scleroderma diagnosis and what things I need to watch for"

I'll do my best.

Scleroderma is also called Systemic Sclerosis, and with good reason ... this disease can affect nearly every organ system.  This property of the disease makes evaluation of non-specific complaints like "shotness of breath" difficult.  Shortness of breath (as an example) in scleroderma can be caused by pulmonary hypertension, lung-scarring from reflux, mechanical impingement of the chest by skin-tightening, deconditioning from fatigue, side-effects from medicines, or from cardiac complications.

Common cardiac complications of scleroderma include coronary artery narrowing, tachycardias, conduction system disease, pericarditis, valvular sclerosis, and direct heart muscle stiffening.  It would be difficult for any person to try to "watch out" for any one of these particular complications.

The key to trying to maintain heart health is to aggressively evaluate symptoms, like shortness of breath.  I would encourage you to seek a very experienced rheumatologist.  If you don't have one in mind, Dr Fred Wigley at Johns Hopkins is a fantastic doctor.

Best of luck.

[tessa0825]

Thank you very much for your reply and the information you have provided me...You gave me something very important, the name of a good Rheumatologist...Doesn't seem to be alot of them around..I am asking for a referral...This is a wonderful forum!