Penicillamine-induced polymyositis with complete heart block.

Complete heart block with severe Adams-Stokes attacks and polymyositis was observed in a 69-year-old man following 6 weeks penicillamine treatment for suspected rheumatoid arthritis. After drug withdrawal the muscle enzymes and the cardiac rhythm gradually normalized, only leaving a right bundle branch block. Although this is the first report to show that severe cardiac damage associated with penicillamine-induced polymyositis is a potentially reversible condition, the severity of the three cases reported so far warrants close observation for cardiac involvement in patients with penicillamine-induced polymyositis.