Patients may also experience symptoms such as joint pain and swelling (similar to arthritis), shortness of breath or persistent coughing (if the lungs are affected), fatigue with very high blood pressure (if the kidneys are affected), chest pains or irregular heart beat (if the heart is affected), heartburn, swallowing difficulties, bowel constipation, diarrhoea or weight loss (if the digestive system is affected) and dry mouth and eyes (if salivary glands and tear ducts are affected). Dental health may be compromised due to difficulty in opening the mouth caused by tight facial skin and dry mouth may lead to tooth decay.