Hyperinsulinism in a child presenting with cardiac ischemia and bradycardia

Area of Science:

• Pediatric Cardiology
• Endocrinology
• Electrophysiology

Background:

• Sinus node dysfunction and ventricular dysfunction can present with varied etiologies in pediatric patients.
• Hypoglycemia is a critical metabolic derangement that can have systemic effects, including cardiovascular manifestations.
• The interplay between metabolic disturbances and cardiac function in children requires further elucidation.

Purpose of the Study:

• To investigate the potential causal link between hypoglycemia and cardiac abnormalities in a pediatric patient.
• To determine the efficacy of glucose administration in resolving hypoglycemia-induced cardiac dysfunction.

Main Methods:

• Case report of a 5-year-old boy with suspected sinus node dysfunction.
• Clinical assessment including evaluation of arrhythmia, mitral valve regurgitation, and ventricular function during a hypoglycemic episode.
• Monitoring of cardiac function and rhythm following glucose infusion.

Main Results:

• The patient presented with arrhythmia and moderate mitral valve regurgitation.
• Ventricular function was depressed during the hypoglycemic episode.
• Cardiac abnormalities resolved completely after intravenous glucose infusion.

Conclusions:

• Hypoglycemia should be considered a potential cause of unexplained cardiac manifestations, including rhythm disturbances and depressed ventricular function, in pediatric patients.
• Glucose infusion is an effective treatment for resolving hypoglycemia-induced cardiac dysfunction.
• Early recognition and management of hypoglycemia are crucial in preventing or reversing cardiac complications.