Emery-Dreifuss muscular dystrophy (EDMD) is a rare genetic condition that primarily affects the skeletal and cardiac muscles. Skeletal muscles are responsible for joint movement, and cardiac muscles are required for the proper functioning of the heart.
Contractures are common in EDMD patients and can appear in early childhood. Stretching and range-of-motion exercises, in consultation with a trained physiotherapist, can help slow the development of joint stiffness and deformity. Active and passive exercises may also help build and maintain muscle strength to prevent the worsening of contractures.
A trained occupational therapist can help patients to adapt their activities to compensate for the loss of muscle strength and to remain independent while performing daily activities.
They may recommend and train patients in the use of assistive devices such as ankle and foot braces to prevent leg deformities, wheelchairs to help with mobility, home modifications such as shower handles, toilet bars, and dressing aids, and communication devices to facilitate interpersonal interaction.
Nearly all EDMD patients have some level of heart complication by age 30. Cardiac conduction block is the most common problem in which there is poor communication between the upper and lower chambers of the heart, disrupting the heart rhythm. This can occur suddenly and can be life-threatening. Therefore, EDMD patients should be monitored regularly for signs of heart block, which can be easily detected on an electrocardiogram.
Insertion of a pacemaker may be required to treat the heart block. A pacemaker is a small device placed under the skin that uses electrical impluses to help the heart beat normally.
In EDMD, the heart muscles can also weaken, causing cardiomyopathy, a condition in which the heart is unable to pump blood properly. Medications such as angiotensin-converting enzyme inhibitors, diuretics, and blood thinners can help improve the functioning of the heart.
Severe cases of cardiac issues may require heart transplants.
In some cases, orthopedic surgery may be required to correct contractures but is usually not performed because of the high rate of contracture reoccurrence.
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