“…Additionally, scleroderma renal crisis and pulmonary hypertension lead to significant cardiac dysfunction secondary to damage in the kidney and lung [4]. Changing axis deviation has been reported [5][6][7][8][9] also during atrial fibrillation [10,11]or atrial flutter [12,13].Changing axis deviation has been also reported during acute myocardial infarction [14][15][16][17][18][19][20][21][22][23][24] associated with atrial fibrillation too [25,26] or at the end of atrial fibrillation during acute myocardial infarction [27]. We present a case of atrial flutter, ventricular tachycardia and changing axis deviation in a 61-year-old Italian woman with scleroderma.…”