[Cardiac complications of dermatopolymyositis. Apropos of 56 cases]

A retrospective study was conducted on 58 patients hospitalized for dermato- or polymyositis between 1967 and 1986, with the view of determining the cardiovascular complications specific to these diseases. The patients' mean age was 51 years, less than 6 months had elapsed between first symptoms and diagnosis, and 31 p. 100 of the patients had died. The electrocardiogram was considered normal in 46 patients, none of whom presented with the slighted clinical evidence of cardiovascular involvement. ECG abnormalities were present in 10 cases, including 5 with disorders of conduction. Five cases of cardiovascular pathology with clinical manifestations were discovered. A 36-year old woman had severe myocardial pathology with marked rhabdomyolysis (CPK greater than 100,000) and complete atrio-ventricular block requiring emergency pacemaker implantation. Three years after the onset of the disease, and whilst the clinical signs of polymyositis had regressed, this patient still had complete AVB and moderately dilated congestive cardiomyopathy. This study shows that cardiac complications of dermato-polymyositis are rare and predominantly consist of disorders of conduction which may become permanent and associated with alterations of left ventricular kinetics. The authors suggest that a high-risk category for patients with disorders of conduction and cardiomyopathy can be identified by echocardiography, but this examination needs mainly be performed in cases when ECG abnormalities are present, since no clinical cardiac pathology was observed in patients of this series with normal electrocardiogram.