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Isolated Right Ventricular Failure in Scleroderma Heart Disease

George, Benjamin J. CPT, MC*; Kwan, Michael D. MAJ, MC†; Morris, Michael J. LTC, MC‡

Finalist, Fellowship/Residency Clinical Case Contest

Scleroderma is reported to have numerous cardiac manifestations. Right ventricular failure (RVF) is a well-recognized cardiac complication of scleroderma and most often is related to underlying pulmonary hypertension (PH). Causes of PH include both interstitial lung disease and pulmonary artery vasculopathy. Direct involvement of the ventricle by myocardial fibrosis or coronary vasospasm could also cause a diffuse bilateral cardiomyopathy. We describe a case of predominant RVF in the absence of significant PH in a patient with longstanding scleroderma.

From the *Internal Medicine Residency, Department of Medicine, the †Cardiology Service, Department of Medicine, and the ‡Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the opinion of the Department of the Army or the Department of Defense.

Reprints: CPT Benjamin J. George, (MCHE-MD), Department of Medicine, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200. E-mail: Benjamin.george@amedd.army.mil

© 2004 Lippincott Williams & Wilkins, Inc.