Possible problems

Hypertension: Secondary to steroids, particularly in younger, ambulant boys. 6-9

Cardiomyopathy: More common in non-ambulant teenagers and adults.

Tachycardia: Commonly noted feature of the disease and also noted in systolic dysfunction. New onset sinus tachycardia with no clear aetiology warrants prompt cardiology assessment.9

Abnormalities in cardiac rhythm should be promptly investigated with Hotter monitoring or an event monitor recording, and treated.

In Hospital

Cardiovascular compromise – needs urgent assessment. Assess Airway, Breathing and Circulation.

  • Assess 02 saturation, treat with 02 carefully and monitor 02.
  • Fluid balance – may need restricted +/- diuretics.
  • Early discussions with local cardiology team or their specialist is recommended.

Patients with Duchenne develop left ventricular dysfunction and there is evidence that early treatment with ACE inhibitors and beta blockers can be cardio protective.