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

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. 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. 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. The patient was successfully treated with empiric antibiotic therapy and amiodarone, respiratory and physical therapy. The patient was discharged on day 34, however oxygen weaning was not possible. 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.