A Tight Squeeze - Cardiac Tamponade in a Scleroderma Patient.

Systemic Sclerosis (SSc) is an autoimmune connective tissue disease marked by multiorgan fibrosis, including cutaneous involvement, and vasculopathy. Primary heart involvement in systemic sclerosis (SSc-pHI) includes heart failure, arrhythmia, pericarditis, pericardial effusion, valve disorders, and myocarditis. SSc-pHI remains a leading cause of mortality in this population. Pericardial effusion in SSc is usually associated with heart failure, pulmonary hypertension, and end-stage kidney disease. Cardiac tamponade is a rare initial presentation of SSc-pHI but carries a worse prognosis. Diagnosis is often challenging due to subclinical manifestations and requires advanced imaging modalities such as transthoracic echocardiography with tissue doppler and cardiac magnetic resonance imaging. Further research is necessary to elucidate pathogenic mechanisms and identify biomarkers essential for targeted therapy and improved clinical recommendations for this subgroup. This report presents a patient with SSc who presented with cardiac tamponade leading to cardiac arrest.