Your Scleroderma Questions, Answered is a monthly Q&A column featuring responses from the SRF’s Chief Medical Officer, Dr. Gregory Gordon, who shares guidance grounded in decades of clinical expertise.
In this edition, he explores the benefits of exercise for people living with ILD, as well as the routine tests that can be critical in early diagnosis of lung and heart complications.
Question: Does regular exercise in someone with mild interstitial lung disease reduce the risk of developing pulmonary hypertension or other heart complications?
Answer: Regular exercise is beneficial for everyone, supporting heart health, wellbeing, and overall fitness. For people with systemic sclerosis, these benefits are particularly important. Research suggests that exercise can improve flexibility, reduce joint stiffness, maintain muscle strength and support overall cardiovascular fitness.
For patients living with lung and heart complications of scleroderma, exercise programs can improve exercise capacity, the ability to perform daily activities and overall quality of life, even if the exercise does not reverse the underlying disease.
It is important, however, for patients with systemic sclerosis to speak with their doctor before starting or changing an exercise routine, particularly if they have significant heart or lung involvement. Some patients may need a formal exercise test first to ensure it is safe to increase their activity level.
Question: Which tests are most important for early detection of lung or heart complications?
Answer: Early detection of heart or lung disease in systemic sclerosis begins with a physical exam. Listening to the lungs and heart and checking for ankle or leg swelling often leads to noticing the first signs of worsening disease. Routine blood work is also important, as it can sometimes reveal early changes, before a patient notices any symptoms. Finding problems early allows for faster, and often more successful, treatment.
Key routine tests for the lungs include pulmonary function testing (PFTs) and CT scans. PFTs measure how much air the lungs can hold and how efficiently they transfer oxygen into the blood. A CT scan provides detailed images of the lung tissue and can detect early scarring that would not appear on a standard chest X-ray. For the heart, the most common routine test is an echocardiogram (or “echo”), which shows the structure of the heart and estimates how well it is functioning.
How frequently a patient undergoes these tests is determined by that person’s history and risk factors. Moreover, a patients should not wait for their next scheduled appointment if they notice new symptoms, such as worsening shortness of breath or difficulty with activities they could previously manage. These changes may need prompt attention.
