Glucocorticoid Therapy for Duchenne Cardiomyopathy: A Hobson’s Choice?

Doubt is not a pleasant condition, but certainty is an absurd one.1 As if receiving a diagnosis of Duchenne muscular dystrophy (DMD) were not terrible enough, consider the impact when a parent learns of the disease’s progressive and inexorable effects on their son’s heart.2 A relentless search for effective therapies against relentless cardiomyop-athy ensues. Those with access to well-informed teams at centers dedicated to interdisciplinary DMD care may get timely and sensitive screening for cardiac involvement, with institution of agents such as angiotensin-converting enzyme inhibitors and b-blockers that benefit a broad spectrum of myocardial diseases.3,4 Those without access to such centers may themselves have to educate less-experienced clinicians on appropriate diagnostic testing and medica