Clinical entity Symptoms and signs Investigations Myocardial fibrosis Exertional dyspnea, Chest radiograph orthopnea, angina EKG pectoris Echocardiogram Distant heart Gated nuclearsounds, gallop ventricular scans rhythm, arrhythmias Pulmonary Cough, dyspnea Chest radiograph, interstitial Dry crackles EKG fibrosis Pulmonary function Cor pulmonale tests, including CO diffusion High-resolution CT, bronchoalveolar lavage Lung biopsy Pulmonary Acute dyspnea Chest radiograph hypertension Increased P2 and EKG Echocardiogram widely split S2 Right-sided heart catheterization Lung biopsy Scleroderma Severe headache, Electrolytes, BUN renal crisis blurred vision, Creatinine congestive heart Plasma renin activity failure, seizures Malignant hypertension, retinopathy Impending gangrene Pain, loss of Cryoglobulins sensation in distal Doppler flow studies digits Trophic changes Treatments Digoxin Diuretics Antiarrhythmics Corticosteroids Oxygen, bronchodilators Treatment of rightsided heart failure Corticosteroids Calcium-channel blockers ACE inhibitors Direct PA installation of vasodilators Captopril and other ACE inhibitors Minoxidil and other vasodilators, βblockers Diuretics, dialysis; in refractory cases, nephrectomy Topical vasodilators Sympathetic ganglionic blockade (digital, regional), prostaglandin E1 infusion