FKTN and LMNA mutations may involve both cardiac and skeletal muscle, consistent with limb-girdle muscular dystrophy (LGMD), with cardiac disease sometimes preceding neuromuscular symptoms.<h4>Case summary</h4>We report on 2 adults presenting with advanced DCM requiring heart transplantation, who were later diagnosed with LGMD. The gene discussed is FKTN; the disease is familial dilated cardiomyopathy.