BACKGROUND: Cardiac involvement may precede the onset of muscular manifestations in Becker muscular dystrophy (BMD), but Wolff-Parkinson-White (WPW) syndrome has not been reported as initial cardiac manifestation of BMD. CASE STUDY: In a 43-year-old, HIV-negative male, WPW syndrome was diagnosed at age 26 years upon a routine surface ECG, carried out for recurrent palpitations since childhood. Since then, WPW syndrome was occasionally found on repeated cardiologic follow-up investigations. From age 27 years, he developed proximal muscle weakness predominantly of the lower limbs, a positive Gower sign, and a waddling gait. Needle electromyograms were repeatedly myogenic, and upon reinvestigation at age 42 years, a deletion of exons 45-47 in the dystrophin gene was detected. Radiofrequency catheter ablation, initially refused by the patient, was scheduled again but no accessory pathways were detected on electrophysiological investigations. CONCLUSION: This case suggests that intermittent WPW syndrome may be a cardiac manifestation of BMD and that cardiac involvement may precede the development of evident skeletal muscle abnormalities.
BACKGROUND: Cardiac involvement may precede the onset of muscular manifestations in Becker muscular dystrophy (BMD), but Wolff-Parkinson-White (WPW) syndrome has not been reported as initial cardiac manifestation of BMD. CASE STUDY: In a 43-year-old, HIV-negative male, WPW syndrome was diagnosed at age 26 years upon a routine surface ECG, carried out for recurrent palpitations since childhood. Since then, WPW syndrome was occasionally found on repeated cardiologic follow-up investigations. From age 27 years, he developed proximal muscle weakness predominantly of the lower limbs, a positive Gower sign, and a waddling gait. Needle electromyograms were repeatedly myogenic, and upon reinvestigation at age 42 years, a deletion of exons 45-47 in the dystrophin gene was detected. Radiofrequency catheter ablation, initially refused by the patient, was scheduled again but no accessory pathways were detected on electrophysiological investigations. CONCLUSION: This case suggests that intermittent WPW syndrome may be a cardiac manifestation of BMD and that cardiac involvement may precede the development of evident skeletal muscle abnormalities.