Related Experiment Videos
Cardiac hypertrophy associated with ACTH therapy for childhood seizure disorder
R S Young1, R R Fripp, D R Stern
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
Insights
Adrenocorticotropic hormone (ACTH) therapy can cause hypertrophic cardiomyopathy, a serious heart condition. Infants treated with ACTH for seizures who develop hypertension require echocardiography to screen for this potentially fatal complication.
Area of Science:
- Cardiology
- Pediatrics
- Endocrinology
Background:
- Adrenocorticotropic hormone (ACTH) therapy is used for various pediatric conditions.
- Systemic hypertension is a known side effect of ACTH therapy.
- Hypertrophic cardiomyopathy (HCM) is a cardiac condition characterized by thickening of the heart muscle.
Observation:
- An infant treated with ACTH for seizures developed severe systemic hypertension.
- Echocardiography showed marked cardiac hypertrophy, with disproportionate thickening of the interventricular septum.
- Reducing ACTH dosage lowered blood pressure but did not reverse cardiac hypertrophy.
Findings:
- ACTH therapy can lead to a newly recognized, potentially fatal complication of hypertrophic cardiomyopathy.
- Infants receiving ACTH therapy who develop hypertension are at risk for HCM.
- Routine echocardiographic evaluation is crucial for early detection.
Implications:
- This study highlights the importance of monitoring cardiac function in infants undergoing ACTH therapy.
- Early identification of HCM through echocardiography can guide treatment adjustments.
- Understanding this complication is vital for pediatricians and endocrinologists managing patients on ACTH.
Abstract:
Hypertrophic cardiomyopathy is a newly recognized, potentially fatal complication of ACTH therapy. We report the clinical, echocardiographic, and pathologic findings of an infant who was treated with ACTH for seizure disorder and subsequently developed severe systemic hypertension. Echocardiography revealed marked cardiac hypertrophy with disproportionate septal hypertrophy. Decreasing the dose of ACTH reduced the systemic blood pressure, but the cardiac hypertrophy progressed and the child subsequently died. Children who develop hypertension during ACTH therapy should be considered at risk for hypertrophic cardiomyopathy and should undergo routine echocardiographic evaluation.