In 1901, Leopold Laquer from Frankfurt, Germany, described a 30-year-old man with myasthenia gravis (MG) who developed cardiac insufficiency with tachycardia and dyspnea and who had unilateral ptosis, difficulties in deglutition, and weakness of the arms. Dr Laquer believed that the muscular disorder had spread to the heart muscle and coined the term Herzmyasthenie, myasthenia of the heart.1
The patient died of respiratory failure, and the autopsy was performed by Carl Weigert, one of the leading pathologists of his time.2 Weigert found that the patient had a tumor of the thymus gland, consisting of lymphocytes and epithelioid cells. The tumor was adherent to the pericardium and infiltrated the thymic veins. He also found a massive lymphocytic infiltration of the deltoid muscle, less in the heart, and he interpreted the muscle findings as metastases from the malignant thymus tumor.