Pneumonia and de novo atrial fibrillation in a patient with myotonic dystrophy type 1: A case report.

INTRODUCTION

Myotonic dystrophy type 1 is a rare genetic disorder that mainly affects the musculoskeletal system; However, it may cause several complications in other body systems representing challenges for health care providers.

PATIENT CONCERNS: We present the case of a patient with a history of previously diagnosed type 1 myotonic dystrophy who presented to the emergency department with cough dyspnea, and thoracic pain.

DIAGNOSIS: Differential diagnoses included pulmonary embolism with a moderate probability according to the Wells score, acute coronary syndrome, acute heart failure, and pneumonia. Diagnostic workup involved chest radiography, EKG, and a CTPA which revealed pneumonia, posteriorly the patient presented de novo atrial fibrillation.

INTERVENTIONS: The patient was successfully treated with empiric antibiotic therapy and amiodarone, respiratory and physical therapy.

OUTCOMES: The patient was discharged on day 34, however oxygen weaning was not possible.

CONCLUSION

Treatment of MD1 patients is challenging due to the various mechanisms of the disease; patients with new-onset deterioration should be screened for the most common complications such as cardio-respiratory events.The authors suggest pneumonia as a risk factor for basal respiratory function deterioration and a contributing factor for triggering cardiac events for further research in prospective studies.