Abstract
Systemic sclerosis (SSc), or scleroderma, is a multisystem disease process that can result in significant end-organ damage if left undiagnosed or untreated. While some manifestations are well-known and widely researched, other presentations of SSc, including the presentation of our patient, require further investigation. Though many non-pulmonary and non-dermatologic manifestations lack widespread recognition, such presentations are important to recognize clinically in order to adequately investigate and appropriately treat. Fibrotic changes affect not only the skin but also the myocardial conduction system which can result in chronic systolic heart failure and significant conduction delays. This report is a case of newly diagnosed scleroderma that presented with worsening dyspnea and activity intolerance who was discovered to have new onset prolonged PR interval, right bundle branch block, and left anterior fascicular block. After a comprehensive workup, the patient was diagnosed with scleroderma and underwent treatment by a multidisciplinary team.