Myocardial fibrosis in polymyositis

Myocardial involvement in polymyositis is commonly suspected in noninvasive studies, but symptomatic cardiac disease is rare. We describe a 27-year-ol d woman with a 6 year history of seven polymyositis and persistent elevatio n of creatine phosphokinase-MB isoenzyme who suddenly developed congestive heart failure and bradycardia-tachycardia syndrome. Autopsy revealed severe myocardial fibrosis without inflammatory cell infiltrates concomitant to a ctive polymyositis of the skeletal muscles despite intensive longterm immun osuppressive therapy.