Systemic sclerosis and tachycardia-bradycardia syndrome: a case report

J Med Case Rep. 2022 Jun 21;16(1):258. doi: 10.1186/s13256-022-03462-z.

Abstract

Background: Systemic sclerosis is a multisystemic character autoimmune disease. It is characterized by vascular dysfunction and progressive fibrosis affecting mainly the skin but also different internal organs. All heart structures are commonly affected, including the pericardium, myocardium, and conduction system. However, tachycardia-bradycardia syndrome is not common in the literature as a cardiac complication of systemic sclerosis. Case presentation We report a case of tachycardia-bradycardia syndrome in a 46-year-old Moroccan woman followed for systemic sclerosis with cutaneous, vascular, and articular manifestations. The diagnosis was based mainly on patient-reported symptoms and electrocardiogram data. A permanent pacemaker was implanted, allowing the introduction of beta-blockers with good outcomes.

Conclusions: This case aims to show that even minor electrocardiogram abnormalities should be monitored in this group of patients, preferably by 24-hour ambulatory electrocardiogram because they could be a good indicator of the activity and progression of cardiac fibrosis.

Keywords: 24-hour ambulatory ECG; Case report; Sick sinus syndrome; Systemic sclerosis; Tachycardia–bradycardia syndrome.

Publication types

  • Case Reports

MeSH terms

  • Bradycardia* / diagnosis
  • Bradycardia* / etiology
  • Electrocardiography
  • Female
  • Humans
  • Middle Aged
  • Scleroderma, Systemic* / complications
  • Scleroderma, Systemic* / diagnosis
  • Sick Sinus Syndrome / complications
  • Sick Sinus Syndrome / diagnosis
  • Tachycardia / etiology