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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 …
Competing interests: None declared.
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