• We describe a 26-year-old man with a predominantly distal myopathy and complete heart block. A muscle biopsy specimen demonstrated numerous vacuoles, which, by electron microscopy, contained membranous whorls. Filamentous inclusions characteristic of inclusion body myositis were not seen. It is important to be aware that life-threatening cardiac disease may occur in this setting.
Krendel DA, Gilchrist JM, Bossen EH. Distal Vacuolar Myopathy With Complete Heart Block. Arch Neurol. 1988;45(6):698–699. doi:10.1001/archneur.1988.00520300118032
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