Clinical spectrum and outcomes of pericardial and myocardial disease in systemic sclerosis: a multicentre case series and literature review.

Severe cardiac manifestations in SSc frequently occur early in the disease, presenting as tamponade or myocardial involvement. Reliance solely on imaging may lead to myocarditis underdiagnosis. Distinct clinical profiles between AM and CIC point toward separate phenotypes with unique prognostic and therapeutic considerations. Large-scale, prospective studies are essential to refine early diagnostic approaches and optimize treatment.