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Left ventricular hypertrophy with outflow tract obstruction-a complication of dexamethasone treatment for subglottic

Rick Balys1, John Manoukian, Christian Zalai

  • 1McGill University, Department of Otolaryngology, Montreal Children's Hospital, Montreal, Canada.

International Journal of Pediatric Otorhinolaryngology
|January 20, 2005
PubMed

Insights

This is the first reported case of steroid-induced obstructive cardiomyopathy in a child treated for subglottic stenosis. This serious side effect of dexamethasone requires early intervention to prevent complications.

Area of Science:

  • Pediatric Cardiology
  • Neonatology
  • Otolaryngology

Background:

  • Subglottic stenosis often requires treatment with corticosteroids like dexamethasone.
  • Premature infants are particularly vulnerable to certain medication side effects.

Observation:

  • A 4-month-old infant (44 weeks corrected gestational age), born prematurely at 27 weeks, developed obstructive cardiomyopathy during dexamethasone treatment for subglottic stenosis.
  • The infant presented with tachycardia, a new cardiac murmur, increased oxygen needs, reduced urine output, and poor peripheral perfusion.

Findings:

  • This case represents the first documented instance of steroid-induced obstructive cardiomyopathy in a pediatric patient beyond the neonatal period (specifically at 44 weeks corrected gestational age).
  • Serial echocardiograms confirmed the diagnosis and monitored the patient's recovery.

Implications:

  • Otolaryngologists and neonatologists should be aware of the potential for dexamethasone to cause obstructive cardiomyopathy, even in post-neonatal infants.
  • Early recognition of cardiac hypertrophy signs and prompt intervention can prevent severe complications associated with this steroid side effect.

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