Myotonic dystrophy as a potential killer

A 19-year-old man suffered a cardiac arrest during a promenade with his friends. Cardiac resuscitation was started immediately. Anamnesis uncovered that the father as well as a cousin of the patient suffered from myotonic dystrophy (MD). Follow-up ECG monitoring showed intercurrent III degree AV-block as well as several asymptomatic episodes of ventricular tachycardias, atrial flutter with changing conduction and atrial fibrillation. Neuromuscular testing and genetic analyses confirmed the diagnosis of a myotonic dystrophy. Myotonic dystrophy (MD) is a chronic, slowly progressing, autosomal dominant inherited multisystemic disease.The clinical presentation is characterized by wasting of the muscles with delayed relaxation, cataracts and endocrine changes. MD is associated with both cardiac conduction disturbances and structural heart abnormalities. Electrocardiographic abnormalities include conduction disturbances or tachyarrhythmias. This case illustrates that potentially lethal arrhythmias inducing sudden cardiac death may occur in MD patients even in the absence of neurologic symptoms characterizing the systemic illness.

Le vicus de Bliesbruck et la villa de Reinheim. Une association inégale

Le Parc archéologique européen de Bliesbruck-Reinheim fait partie des sites archéologiques les plus visités des provinces du nord-ouest de l’Empire romain. On se trouve là non seulement dans un lieu de promenade agréable occupé très tôt par les hommes, mais on flâne aussi à travers un vicus, une petite ville romaine, on entre dans ses maisons pour y regarder leur aménagement, on s’attarde dans des thermes publics bien conservés et on se sent plongé dans l’histoire des premiers siècles de notre ère.