Abstract
Acute Onset of Persistent Tachycardia in a Patient with Duchenne Muscular Dystrophy
Highlights
A 10-year-old wheelchair dependent male with Duchenne Muscular Dystrophy, on chronic corticosteroid therapy, presented with persistent tachycardia
D-dimer returned elevated at 1541 NG/ML fibrinogen equivalent units (FEU)
Fat embolism syndrome secondary to distal metaphyseal tibial fracture in a patient with Duchenne Muscular Dystrophy
Summary
A 10-year-old wheelchair dependent male with Duchenne Muscular Dystrophy, on chronic corticosteroid therapy, presented with persistent tachycardia. Later that same day he developed fever and described his “heart racing.”. He reported some mild chest tightness and a nonproductive cough. The review of systems was otherwise unremarkable. On physical examination, his temperature was 38.3°, heart rate 149 beats per minute, respiratory rate 20 breaths per minute, normal blood pressure, oxygen saturation 93% on room air, and body mass index 40.36 kg/m2. Cardiac examination revealed tachycardia without murmurs, gallops or rubs; peripheral pulses and capillary refill were normal. A respiratory viral panel, troponin, brain natriuretic peptide and echocardiogram were normal. Computed tomography anigography revealed bilateral diffuse, scattered ground-glass opacities with areas of nodular consolidative opacities in a somewhat gravity-dependent pattern; there were multiple peripheral wedge-shaped arterial-distribution opacities with areas of interlobular septal thickening consistent with infarctions (Figure 1)
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