Nemaline Myopathy Presenting as Cardiomyopathy

Abstract
To the Editor: We report a case of nemaline myopathy that presented as fatal cardiomyopathy in a 29-year-old woman.After having noticed episodes of dyspnea over several months, the patient had retrosternal pain, dizziness, dyspnea, and anxiety. Clinical examination revealed a leptosomal habitus but no myopathic stigmata and no neuromuscular abnormalities. The pulse rate was 110 per minute, and the blood pressure was 90/70 mm Hg. Chest roentgenograms showed cardiomegaly. The predominant alteration in the echocardiogram was a dilated left ventricle without hypertrophy and a reduction of the shortening fraction to 15 per cent. The mitral valve was normal. Right-heart . . .

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