Congestive heart failure after physical exercise in a young patient with myotonic dystrophy type 1

Cardiac involvement, such as conduction defects, is common in myotonic dystrophy type 1 (DM1), but congestive heart failure (CHF) is rare in young patients. A 21-year-old recruit was admitted in the department of cardiology with acute CHF after daily physical exercise for about one week in the boot camp. After recovery, neurologic consultation was requested for his general weakness and lean body mass. He was diagnosed as DM1. He denied any prior cardiac symptoms. We cautiously postulated that excessive physical activity might contribute to develop CHF in DM1 patients. Other possible mechanisms will be discussed. Comprehensive cardiac evaluation might be helpful to identifying high-risk patients early to prevent cardiac complications, even without cardiac symptoms.