Electrocardiogram in progressive systemic sclerosis. Analysis of 73 cases.
Electrocardiographic abnormalities were found in 53 out of 73 patients (72,6%) affected with progressive systemic sclerosis or scleroderma. Along with some modifications of little value, like heart rate increase or decrease, sporadic premature beats, slight ST depression or T-wave flattening, other more important abnormalities were recorded. One patient had atrial fibrillation and one supraventricular tachycardia. In 21 cases (28.8%) conduction disorders were found, including A-V block, right bundle branch block, left anterior hemiblock and bifascicular block. Low QRS voltages were present in 15 cases (20,6%), confined in all but one to the peripheral leads. In 13 patients (17,8%) Q or QS aspects suggesting myocardial necrosis were observed, but a clinical history or clinical picture of myocardial infarction syndrome was lacking in all cases but one. Electrocardiographic patterns of myocardial necrosis in scleroderma may indicate not only myocardial infarction, which seems to be a rather rare occurrence in such disease, but also intraventricular conduction system defects or progressive replacement of myocardium by fibrous tissue.