Article Text

PDF
CASE REPORT
Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis
  1. Patricia Moniz,
  2. Daniel Rei,
  3. Joana Rodrigues,
  4. Arturo Botella
  1. Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar Lisboa Ocidental/NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
  1. Correspondence to Dr Patricia Moniz, patricia.moniz25{at}gmail.com

Summary

A 51-year-old female patient with a recent hospital admission reported to the emergency room (ER) with progressive worsening of fatigue, dyspnoea and chest discomfort. She had been recently admitted and discharged with the diagnosis of pericarditis and medicated with non-steroidal anti-inflammatory drugs and diuretics. She returned to the ER with persisting symptoms. Echocardiography was repeated and showed signs of elevated right ventricular systolic pressure and a slightly increased moderate/severe pericardial effusion without signs of cardiac tamponade. The patient was admitted and further evaluation confirmed an underlying case of advanced systemic sclerosis with skin, vascular, pulmonary and cardiac involvement. The patient was referred to specialised consults in autoimmune pathology and pulmonary arterial hypertension. She was started on bosentan and corticosteroids, presenting a favourable clinical evolution although symptoms of exertional dyspnoea persist.

  • rheumatology
  • pulmonary hypertension
  • pericardial disease

Statistics from Altmetric.com

Footnotes

  • Contributors All authors participated in the patient’s management during hospital admission. PM wrote the case report and carried out the bibliographic review. AB, DR and JR were consulted during the writing process and assisted in the manuscript’s revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.