Onoda Hiroshi, Imamura Teruhiko, Ushijima Ryuichi, Sobajima Mitsuo, Kinugawa Koichiro
The Second Department of Internal Medicine, University of Toyama, Japan.
Division of Cardiology, Niigata Prefectural Central Hospital, Japan.
Intern Med. 2020 Jun 15;59(12):1531-1533. doi: 10.2169/internalmedicine.4259-19. Epub 2020 Mar 19.
We encountered a 42-year-old woman with a history of diabetes mellitus and cataracts presenting with repeated syncope whose electrocardiogram showed advanced atrioventricular block. On admission, we excluded major potential differential diagnoses as causes of an atrioventricular block but did not suspect myotonic dystrophy, which was eventually diagnosed by chance based on a suspected weakness of the respiratory muscles followed by a detailed neurological physical examination. Myotonic dystrophy should be suspected as a differential diagnosis when relatively young patients present with conductance disorder.
我们遇到一名42岁女性，有糖尿病和白内障病史，反复出现晕厥，其心电图显示高度房室传导阻滞。入院时，我们排除了作为房室传导阻滞病因的主要潜在鉴别诊断，但未怀疑强直性肌营养不良，最终因怀疑呼吸肌无力随后进行详细的神经体格检查偶然确诊。当相对年轻的患者出现传导障碍时，应怀疑强直性肌营养不良作为鉴别诊断。
