Cardiac Rehabilitation in Myasthenia Gravis

Introduction: Myasthenia Gravis (MG) is characterized by muscle weakness that may be exacerbated with exercise. Research on safety of exercise in MG is scarce. Patients are frequently discouraged from participation. At the same time, exercise-based cardiac rehabilitation is a class I recommendation for patients recovering from Myocardial Infarction (MI) and Percutaneous Coronary Intervention (PCI). Rehabilitation of cardiac patients suffering from MG presents a unique challenge for clinicians. Methods: We describe a cardiac rehabilitation (CR) program in a patient status post STEMI (ST-Elevation Myocardial Infarction) and PCI with a fifteen-year history of MG. Results: The patient was able to successfully complete a 36-session program consisting of aerobic, strength and flexibility training, showing marked improvements in aerobic capacity, endurance, and field exercise tests results. No significant adverse events were noted. Conclusion: aerobic and resistance exercise programs are feasible and may be beneficial in cardiac patients with comorbid MG.