Duchenne’s Muscular Dystrophy and heart disease

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Q;

I have a 19 year old son with Duchenne’s Muscular Dystrophy. He also has Supraventricular tachycardia.  He has under gone an atrial flutter ablation and still has arrhythmias.  He is not on any heart medication.
His latest EKG showed RSR rime in V1, non specific T wave changes and sinus rhythm. His heart rate is 100bpm. When he has palppitations his heart reate will increase to 110- 140 bpm. My question is how will this impact my son’s heart, especially with having muscular dystrophy?  Will this create a strain on his heart? Thank you for your time in answering this question.

A:

Patients with Duchenne’s Muscular Dystrophy are at a high risk for both arrhythmias and heart failure and should be followed (and treated) agressively. The heart failure occurs as a “dilated cardiomyopathy”, causing “systolic dysfunction”:
http://www.cardiac-risk-assessment.com/heart-information/heart-failure
http://www.cardiac-risk-assessment.com/ca-blog/heart-function-failure/ (look here for systolic dysfunction).
Treatment often includes angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs)plus Alpha-receptor blockade is clear for cardiomyopathy patients without muscular dystrophy, and there is no reason to avoid this standard regimen in muscular dystrophy patients:
http://www.cardiac-risk-assessment.com/heart-disease-treatment/heart-disease-med
http://www.cardiac-risk-assessment.com/heart-disease-treatment/heart-disease-medLikewise, arrhythmias if present should be evaluated with monitoring and other testing such as a Holter monitor and possibly another EP study:
http://www.cardiac-risk-assessment.com/heart-information/palpitations
http://www.cardiac-risk-assessment.com/heart-information/heart-arrhythmia
Lots of information for you, but I hope this helps,
Dr T
http://www.cardiac-risk-assessment.com/

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