- Angiotensin converting enzyme (ACE) inhibitors should be considered as first-line therapy. Other medicines such as betablockers and diuretics are also appropriate and should follow published guidelines for the management of heart failure. There is some evidence from clinical trials to support the prophylactic treatment of cardiomyopathy with ACE inhibitors prior to any signs of abnormal functioning. Further studies are awaited to allow firm recommendations in this regard.
- Abnormalities of heart rhythm should be promptly investigated and treated. A fast heart rate is a commonly noted harmless feature of DMD, but can also be seen with heart problems. If it develops as a new finding it should be investigated.
- Individuals undergoing treatment with steroids need additional attention from the cardiovascular perspective, especially monitoring for hypertension (high blood pressure). Steroid dose may require adjustment or further treatment may need to be added (see here).