Pneumonia and de novo atrial fibrillation in a patient with myotonic dystrophy type 1: A case report
Fecha
2022-09-30Resumen
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.
Abstract
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.
Keywords
URI
http://repositorio.mederi.com.co/handle/123456789/712https://doi.org/10.1097/md.0000000000030518
Colecciones
- Investigación clínica [389]