Coronary disease in scleroderma; report of two cases

Scleroderma (SSC) is a systemic inflammatory disease characterized by vascular dysfunction and excessive fibrosis which may involve many organs particularly the heart, lungs and kidney. In scleroderma cardiac disease and pulmonary arterial hypertension (PAH) are common findings where as coronary diseases have been reported with a similar frequency or as rare in several studies. Atypical presentation, wide range of differential diagnosis and co morbidities can result in certain difficulties in diagnosing coronary disease in these patients. Hereby, we report two cases with scleroderma and PAH and a mild increased filling pressure in which significant coronary disease was discovered incidentally. Therefore, it seems crucial to perform further studies on the preferred time for evaluating CAD in such patients.