*4.8. Cardiovascular Manifestations*

Raynaud phenomenon is the most frequent vascular manifestation, affecting 15% of patients [207]. Fortunately, cardiac manifestations such as pericarditis, pulmonary hypertension and cardiomyopathy are very rare, affecting <1% of pSS patients, respectively [207]. Cardiac rhythm disturbances have been described, secondary to ionic disorders, dysautonomia or direct impairment of the electrical conduction system of the heart [224,225].
