Severe Cardiomyopathy from Limb Girdle Muscular Dystrophy: A Nidus for a Catastrophic Cascade

We report a case of a 57-year-old female with Limb Girdle Muscular Dystrophy (LGMD) who initially presented to her outpatient physician a year ago with progressive shoulder and pelvic girdle muscle weakness associated with slight limitation of movement, gradual onset of easy fatigability, intermittent episodes of exertional dyspnea, and trace bipedal edema. On the day of admission, she had sudden onset of unresponsiveness due to massive cerebral infarct likely cardioembolic as evidenced by left ventricular thrombus, in the setting of severe cardiomyopathy associated from LGMD. The patient was treated with hemodynamic support and systemic anticoagulation but did not show any signs of neurologic improvement. Comfort care measures were initiated, eventually, the patient succumbed to death.