Mediastinal Abnormalities in Systemic Sclerosis

Figure 1. A 37-year-old woman who had had systemic sclerosis for several years, with known esophageal and skin involvement, presented with dyspnea on exertion and a large pericardial effusion. Transthoracic echocardiography was performed, with parasternal long-axis views obtained before (Panel A) and after (Panel B) pericardiocentesis. The following mediastinal abnormalities are evident: right ventricular hypertrophy due to pulmonary hypertension, left ventricular hypertrophy related to systemic hypertension, a pericardial effusion (PE), and a fluid-filled, dilated esophagus (E) due to esophageal dysmotility. Right ventricular hypertrophy is defined echocardiographically as a right ventricular diastolic free-wall thickness in excess of 5 mm. Normally, the . . .