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Doppler echocardiographic evaluation of an infant with HCM during ACTH therapy
1Department of Pediatrics, Faculty of Medicine, Kagoshima University, Japan.
Insights
Adrenocorticotropic hormone (ACTH) therapy for West syndrome may cause hypertrophic cardiomyopathy (HCM). Doppler echocardiography is sensitive for monitoring these cardiac changes during ACTH treatment.
Area of Science:
- Cardiology
- Pediatric Neurology
- Medical Imaging
Background:
- West syndrome is a severe epilepsy syndrome in infants.
- Adrenocorticotropic hormone (ACTH) therapy is a standard treatment for West syndrome.
- Hypertrophic cardiomyopathy (HCM) has been anecdotally associated with ACTH therapy.
Observation:
- This study details the Doppler echocardiographic evaluation of an infant diagnosed with both West syndrome and HCM.
- The infant received ACTH therapy for West syndrome.
Findings:
- ACTH therapy led to increased interventricular septal thickness.
- A rise in the left ventricular outflow tract pressure gradient was observed.
- Heart rate also increased following ACTH administration.
- Doppler echocardiography demonstrated higher sensitivity in monitoring cardiac alterations compared to 2D echocardiography or heart rate alone.
Implications:
- Doppler echocardiography is a valuable tool for monitoring cardiac changes in infants treated with ACTH for West syndrome.
- Early detection of ACTH-induced cardiac effects, such as HCM, is crucial.
- This highlights the importance of cardiac surveillance during ACTH therapy for pediatric epilepsy syndromes.
Abstract:
Adrenocorticotropic hormone (ACTH) therapy is useful in the treatment of patients with West syndrome, and hypertrophic cardiomyopathy (HCM) in association with ACTH therapy has recently been reported. We describe the Doppler echocardiographic evaluation of an infant who had West syndrome and HCM. ACTH therapy produced increases in the interventricular septal thickness, the pressure gradient of the left ventricular outflow tract, and the heart rate. Doppler echocardiographic examination was found to be much more sensitive for monitoring the cardiac changes than either 2-dimensional echocardiography or the heart rate.