Sudden Death of a Carrier of X-Linked Emery-Dreifuss Muscular Dystrophy

doi:10.1059/0003-4819-119-9-199311010-00006

Sudden Death of a Carrier of X-Linked Emery-Dreifuss Muscular Dystrophy

From Cedars-Sinai-UCLA Medical Center, Los Angeles, California; Center for Handicapped Children and Teenagers, San Francisco, California; Emory University School of Medicine, Atlanta, Georgia. Requests for Reprints: Michael C. Fishbein, MD, Department of Pathology, Room 8732, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048. Acknowledgments: The authors thank Dr. John Carney of the Department of Pathology, Eden Hospital Medical Center, and Dr. Harrison Latta of the Department of Pathology, UCLA Medical Center, for allowing us to review autopsy tissues and sections; and Jean Havercroft for providing secretarial assistance.

Abstract

Objective: To report a sudden death in a female carrier of Emery-Dreifuss muscular dystrophy and to describe the cardiac abnormalities associated with this disease.

Study Design: Case series.

Setting: University hospital.

Patients: A 45-year-old carrier who died suddenly and two affected men who also died of cardiac manifestations of Emery-Dreifuss muscular dystrophy.

Measurements: Post-mortem gross pathologic and histopathologic study of the heart.

Results: All three hearts showed a unique pattern of pathologic findings. Marked loss of atrial myocardium had occurred. Myocardium had been replaced by adipose and fibrous tissue. The conduction system showed no significant abnormalities. Varying degrees of interstitial and replacement fibrosis were present in the ventricular myocardium.

Conclusions: Emery-Dreifuss muscular dystrophy is associated with characteristic pathologic changes in the heart that can cause death in female carriers and affected men. Female carriers should be identified and evaluated because of the risk for sudden cardiac death.