Cardiac involvement in polymyositis was investigated in 20 autopsied cases. Clinically, 13 of 18 patients had abnormal electrocardiograms, and 9 of the 20 patients had previous evidence of congestive heart failure. Histologically documented myocarditis was detected in 6 patients (4 with congestive heart failure and 2 without), 4 of whom also had small vessel disease of the myocardium. Patients with polymyositis may have a cardiopathy in the absence of overt myocardial inflammatory disease.

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Conclusions-Repeated attacks of acute chest syndrome by the mean age of 12 (range eight to 16) years have not had a discernible effect upon pulmonary artery pressure. (Br Heart3J 1993;69:536-538)

tory oliguria, and the development of generalized myalgia and respiratory muscle weakness.No known drug(s) associated with rhabdomyolysis, itself rare, 4 were administered, nor were any metabolic factors present that are capable of potentiating this event. When rhabdomyolysis has been reported in patients undergoing longterm therapy, no acute causative factor is apparent. 3,4 Rosenberg and colleagues, 5 however, have documented intraoperative rhabdomyolysis associated with pravastatin in cases in which the operation was thought to be the trigger. Although speculative, 7 years of uneventful simvastatin therapy in this case, together with the report by Rosenberg's group, indicates to us that the timing of this complication and operation were not coincidental.

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