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Childhood Cardiomyopathies: A Study in Tertiary Care Hospital in Upper Egypt
Mohamed Abd Elaal Bakeet1, Montaser Mohamed Mohamed2, Ahmed Ahmed Allam3
1M.D., Professor of Pediatrics, Faculty of Medicine, Sohag University, Egypt.
Insights
Childhood cardiomyopathy (CMP) is common, with dilated CMP being most frequent and often caused by myocarditis. Early cardiac enzyme screening is recommended for newly diagnosed CMP cases.
Area of Science:
- Pediatrics
- Cardiology
- Medical Research
Background:
- Cardiomyopathy (CMP) is a significant cause of heart failure and heart transplantation in children.
- Data on childhood CMP in Egypt are limited, necessitating local studies.
- This study addresses the scarcity of data on CMP in Egypt.
Purpose of the Study:
- To determine the prevalence, risk factors, clinical presentation, and outcomes of childhood cardiomyopathies.
- To investigate different types of CMP in Egyptian children.
- To provide insights into CMP management in Sohag University Hospital.
Main Methods:
- A cross-sectional study involving fifty children diagnosed with CMP.
- Data collected from Pediatric Departments, Neonatal Care Units, and Cardiac Outpatient Clinics.
- Study conducted over a one-year period (March 2014 - February 2015).
Main Results:
- Dilated Cardiomyopathy (DCMP) affected 76% of cases, Hypertrophic Cardiomyopathy (HCMP) 24%.
- Dyspnea was the most common symptom (71%). Viral myocarditis was the leading cause of DCMP (37%).
- Elevated cardiac enzymes (CK-MB, Troponin I) noted in a small percentage; L-Carnitine profiles were normal.
Conclusions:
- CMP is a considerable pediatric cardiac disorder, with DCMP being most prevalent and often linked to myocarditis.
- Clinical suspicion for CMP should be heightened, as presentations can be atypical.
- Screening with cardiac enzymes and reassessing L-Carnitine use are recommended for newly diagnosed CMP cases.
Introduction:
Cardiomyopathy (CMP) is defined by the World Health Organization (WHO) as a disease of the myocardium associated with cardiac dysfunction. An understanding of CMP is very important, as it is a common cause of heart failure in children, and the most common indication for heart transplantation in children older than one year, but data on CMP in Egypt are scarce. The aim of this study was to determine the number, risk factors, clinical presentation, complications and outcome of different types of childhood cardiomyopathies in Sohag University Hospital.
Methods:
This cross-sectional hospital based study enrolled fifty children with Cardiomyopathy in Pediatric Departments, Neonatal Care Units, and Cardiac Outpatient Clinics in Sohag University Hospital from March 01, 2014 to February 28, 2015.
Results:
Cases with Dilated Cardiomyopathy (DCMP) were 38 (76%), and those who had Hypertrophic Cardiomyopathy (HCMP) were 12 (24%). Dyspnea was the most common presenting complaint in 71% of cases. In cases with DCMP, the mean EF was 33.8, and FS was 17.11, while in cases with HCMP, the mean EF was 70.75, FS was 37. Fifty percent of cases were found to have moderate to severe PHT. Serum CK-MB was elevated in 3 (6%) cases, while serum Troponin I was elevated in 2 (4.2%) cases who diagnosed as having myocarditis. Viral myocarditis was the most common identified etiological agent responsible for 14 (37%) cases with DCMP.
Conclusions:
CMP represents a considerable percentage of children with cardiac disorders. DCMP is the most common type, usually presented with congestive heart failure, and the most common cause is myocarditis. L-Carnitine profile was normal in all cases, despite its routine use. Pediatricians need to raise their clinical suspicion to CMPs, as atypical presentations are not uncommon. To do screening for other family members, cardiac enzymes (CK-MB, Troponin I) have to be done in all newly diagnosed CMP cases, along with a revision of the routine prescription of L-Carnitine.
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