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Tako-tsubo-like syndrome in systemic sclerosis: a sign of myocardial Raynaud phenomenon?
  1. D Melchiorre1,
  2. P Bernardo2,
  3. M L Conforti1,
  4. C Comunian1,
  5. F Nacci1,
  6. S Guiducci1,
  7. G Fiori1,
  8. A Moggi-Pignone3,
  9. G F Gensini2,
  10. M Matucci-Cerinic1
  1. 1
    Department of BioMedicine, Division of Rheumatology, AOUC University of Florence, Florence, Italy
  2. 2
    Department of Medical and Surgical Critical Care, AOUC University of Florence, Florence, Italy
  3. 3
    Division of Medicine II, AOUC University of Florence, Florence, Italy
  1. M Matucci Cerinic, Department BioMedicine, DenoThe Centre, Division of Rheumatology, Villa Monna Tessa, viale Pieraccini 18, 50139 Firenze, Italy; cerinic{at}unifi.it

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An 84-year-old female patient, with limited cutaneous systemic sclerosis (SSc) (Raynaud phenomenon, anticentromere antibodies, active capillaroscopic pattern) presented to the emergency room with fever (38.5°C), cough, no chest pain or dyspnoea, regular heart beat and no cardiovascular risk factors; the patient did however have hypertension (ramipril 2.5 mg/day). Echocardiogram (ECG) revealed inverted T waves in V2–V6 and in the inferior leads (fig 1). Haemoglobin was 9 g/dl (normal value 11–15 g/dl) and troponin I was increased 1.53 ng/ml (0.0–0.15 ng/ml). An echocardiogram showed normal chamber sizes, with mid-apical anterior, mid-apical lateral and apical inferior akinesis with a reduction of ejection fraction (35%): hyperkinesis of the basal segment of …

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