A 38-year-old woman with systemic sclerosis was admitted to our hospital because of dyspnea and finger ulcer. Chest X-p showed cardiomegaly and pleural effusion. Echocardiogram revealed diffuse hypokinesis of the left ventricle (ejection fraction 32%). Thallium scintigraphy demonstrated patchy perfusion defects. She was diagnosed as having congestive heart failure due to myocardial fibrosis, and was treated successfully with diuretics, cardiotonics, and beta-blocker. Scintigraphy may be useful to detect an early cardiac involvement in patients with systemic sclerosis, and intense pharmacological treatment might be started even before the patient develops symptoms.