Severe cardiac conduction disturbance associated with polymyositis

Abstract

We present an unusual case of polymyositis that was complicated by the development of severe cardiac conduction disturbance. This 55-year-old Japanese woman had a history of polymyositis for which she had received corticosteroids for the past 6 years. She then developed palpitations and vertigo for which she was hospitalized. Electrocardiographic abnormalities (right bundle branch block, right axis deviation and atrioventricular block) with a prolongation of H-V time on the His bundle electrogram revealed the presence of a severe cardiac conduction disturbance. The myocardium was biopsied and showed perivascular fibrosis with fatty infiltration. Patients with polymyositis can thus develop cardiac disorders such as severe conduction disturbances. Therefore, attention should be paid to the cardiac condition of these patients.

Key words::

• arrythmia
• electrocardiogram (ECG) abnormality
• His bundle electrogram
• myocardial biopsy
• polymyositis (PM)