Pulmonary hypertension in systemic sclerosis.

A woman born in 1912 (Case 8 in the necropsy series) had an unremarkable family history. In 1940, she first noted blanching and cyanosis of the fingers on exposure to cold. Since 1960, small, hard, subcutaneous nodules developed at different locations on her body. Early in 1968, progressive effort dypsnoea and anginal chest pains started insidiously, and treatment with digitalis, furosemide, and potassium was instituted. In September, 1968, she was admitted to the Medical Clinic for heart catheterization. Anticoagulants, reserpine, and theophylline were added to her regimen, but her condition gradually deteriorated, with fatigue, dyspnoea at rest, anginal pains, ankle oedema, cyanosis, and syncopal attacks. She died on January 26, 1969.