• Cardiac involvement in SSc is common and significantly heterogeneous concerning both prevalence and clinical presentation |
• Cardiac alterations in SSc could also be secondary to other SSc complications (due to pulmonary arterial hypertension, interstitial lung disease, or SSc renal crisis) with relevant prognostic implications |
• Cardiac conduction disease and arrhythmias are quite common, probably related to due to autonomic cardiac neuropathy, myocardial fibrosis into the conduction system, as well as microvascular injury |
• Guideline-directed medical therapy is the current treatment for cardiac complications in SSc |
• To date no specific treatment is available to prevent cardiac complications in SSc |
• Speckle-tracking echocardiography (both of the left and the right ventricles), hemodynamic assessment of RV P/V loops, and endomyocardial biopsy can help in better understanding of the SSc-related cardiac alterations |