Silent myocardial infarction in Wegener's granulomatosis.

Histological cardiac abnormalities in Wegener's granulomatosis can frequently be demonstrated at post-mortem examination, but clinically significant cardiac involvement is rare. We describe a massive silent myocardial infarction leading to intractable heart failure and death in a young man with Wegener's granulomatosis, occurring at a time when other features of the disease were responding to aggressive immunosuppression.