• Cardiac medicines should be started with the first sign of cardiac fibrosis (scar tissue forming in the heart muscle, seen on MRI), decreased heart function (seen by decreased ejection or shortening fraction on MRI or echocardiogram) or by age 10, even if all your tests are normal as this will help to protect your heart
  • Angiotensin converting enzyme inhibitors (ACEi – lisinopril, captopril, enalapril, etc.) or angiotensin receptor blockers (ARB – losartan) should be considered as first-line therapy. These medicines open up the blood vessels leading out of your heart, so your heart doesn’t need to squeeze as hard to pump blood to the body
  • Other medicines, such as beta-blockers slow the heart rate down so that the heart can fill and pump blood effectively. Diuretics (“water pills” that cause the body to get rid of fluid, reducing the volume of the blood, allowing the heart to not pump as fast and hard) may also be prescribed with progession of heart failure
  • Abnormal heart rhythms shown on an ECG should be promptly investigated and treated. It is a good idea to keep a copy of your baseline ECG on hand
  • A Holter monitor will evaluate your heart rate and rhythm for 24 or 48 hours; this is done if changes in your heart rate or rhythm are suspected and need further evaluation
  • A fast heart rate and/or palpitations (occasional abnormal heart beats) are common in people living with Duchenne and are typically not harmful. However, these can also be associated with more serious heart problems and need to be investigated by a cardiologist
  • If you are experiencing severe, persistent chest pain, this may be a sign of cardiac damage, and you should be evaluated immediately in an emergency department
  • People taking steroids should be monitored for potential cardiac side effects, such as hypertension (high blood pressure) and hypercholesterolemia (high cholesterol); steroid dose may require adjustment or further treatment may need to be added (see Table 2 in section: Steroid Side Effects: Recommended Monitoring and Intervention)