Muscle Diseases and the Heart’s Silent Drama
In society, many people associate muscle diseases solely with difficulty walking, weakness, or the use of a wheelchair. Yet these conditions have an invisible but vital dimension: the heart. Because the heart is also a muscle. Genetic or metabolic disorders that strike skeletal muscles often affect the heart muscle as well. This is why muscle diseases are not only a neurological issue but also a critical domain of cardiology.
On the website of the Muscular Diseases Association of Turkey (KASDER), the “disease types” section lists numerous diagnoses such as Duchenne and Becker muscular dystrophies, myotonic dystrophy, metabolic myopathies, congenital muscle diseases, ALS, and myasthenia gravis. What they all share is progressive loss of muscle strength. But in many of these conditions, this loss is not confined to skeletal muscles.
Duchenne and Becker dystrophies:
Beginning in childhood, these diseases can cause severe damage to the heart muscle during adolescence or early adulthood. The heart’s pumping ability decreases, and dilated cardiomyopathy may develop.
Myotonic dystrophy:
Beyond muscle stiffness and impaired relaxation, life-threatening cardiac arrhythmias can occur.
Emery–Dreifuss dystrophy:
This disorder particularly affects the heart’s electrical conduction system, and sudden cardiac arrest can be seen.
Metabolic myopathies:
When muscle cells cannot produce energy, the heart shares the same fate.
Clearly, muscle diseases attack not only the arms and legs but also the heart — the engine of life.
Unfortunately, this fact often remains overshadowed by the primary disease. Children or adults diagnosed with a muscle disorder struggle so much with mobility issues that cardiac problems are pushed into the background. Yet deterioration in the heart muscle often begins years before the first symptoms appear. In other words, the heart wears down silently.
Without regular cardiac evaluations, patients may present with fatigue, shortness of breath, or palpitations only when it is already too late. Delayed diagnosis reduces the effectiveness of treatment. However, tools such as echocardiography, ECG, and MRI can detect these changes early.
Muscle diseases are not only a medical issue but also a social one, as most are genetically inherited. Families whose children receive such diagnoses must be informed about cardiac risks as well. Other relatives should be evaluated for potential risk, and genetic counseling should be provided.
Public awareness of muscle diseases is low. Conditions like ALS, wheelchair use, or occasionally DMD are known, but the fact that these disorders can lead to heart failure, sudden death, or heart attacks is far less recognized. Yet access to cardiac care is just as crucial as social support, public health policies, and participation in education or employment.
With a multidisciplinary approach, muscle diseases fall under the domains of neurology and genetics as much as cardiology. Once diagnosed, a cardiac assessment must be performed, and even children should have their heart function monitored. Annual evaluations can detect early changes in the heart muscle. Heart failure can be treated with medications; arrhythmias with pacemakers or ICDs. It is the responsibility of associations, the media, and newspapers to make these issues visible.
Muscle diseases threaten not only muscle strength but also the rhythm of life itself. When we consider that every heartbeat is a muscular movement, we realize that these disorders are about far more than movement alone. Newspaper columns should reflect not only daily politics but also the silent cries of society. The link between muscle diseases and heart health is one such cry. Hearing it, amplifying it, and seeking solutions is the duty of the press, physicians, and the public.
