Heart failure and atrial flutter as a manifestation of myotonic dystrophy type 1 Abstract Myotonic dystrophy is a hereditary disease of the neuromuscular system with cardiac impairment, mainly showing rhythm disturbances and atrioventricular conduction defects, and rarely heart failure. We report the case of a 37 year-old patient who was admitted for acute heart failure and atrial flutter associated with long standing progressive muscle weakness. A diagnosis of myotonic dystrophy type 1 was made after complementary studies. A short review of the literature about this pathology and the cardiac manifestations is presented. © 2015 Sociedad Colombiana de Cardiologia y Cirugia Cardiovascular. Published by Else- vier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).