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[Secondary myocardial hypertrophy in newborn infants and infants without congenital heart defect]
R Oberhoffer1, C Kupferschmid, D Lang
1Abteilung Pädiatrie I, Universitäts-Kinderklinik, Ulm, Bundesrepublik Deutschland.
Insights
Secondary hypertrophic cardiomyopathy (HCM) in infants often resolves when the underlying cause is addressed. Echocardiography confirmed HCM in newborns and infants, with resolution observed after removing causative factors.
Area of Science:
- Pediatric Cardiology
- Neonatology
- Cardiovascular Pathology
Context:
- Secondary hypertrophic cardiomyopathy (HCM) can affect newborns and infants.
- Echocardiography is a key diagnostic tool for assessing cardiac structure and function.
- Identifying the underlying cause of HCM is crucial for effective management.
Purpose:
- To investigate the characteristics and outcomes of secondary HCM in a cohort of newborns and infants.
- To determine the reversibility of echocardiographic findings of HCM after addressing causative factors.
- To emphasize the importance of excluding secondary causes before diagnosing primary HCM.
Summary:
- This study diagnosed secondary hypertrophic cardiomyopathy (HCM) in 55 newborns and infants without pre-existing heart conditions.
- Infants included those born to diabetic mothers, treated with ACTH, premature with bronchopulmonary dysplasia, or with other underlying diseases.
- Echocardiographic evidence of HCM resolved in most cases after the removal of the causative factor, highlighting the condition's secondary nature.
Impact:
- The findings suggest that secondary HCM is often reversible, emphasizing the need for thorough etiological investigation.
- Early identification of triggering agents for HCM can guide further diagnostic procedures and management strategies.
- This research supports the diagnostic approach of excluding secondary causes before diagnosing primary HCM in pediatric populations.
Abstract:
Secondary hypertrophic cardiomyopathy (HCM) was diagnosed in 55 newborns and infants without heart disease. The 17 newborn infants of diabetic mothers, 23 infants given ACTH treatment for infantile spasms, 9 ventilated premature infants or babies with bronchopulmonary dysplasia and 6 infants with different underlying diseases comprising this group underwent 2-dimensional echocardiography. In almost all cases echocardiographic evidence of HCM resolved after removal of the exogenous or endogenous causative factor. Myocardial effects of several substances are known and their pathophysiological mechanisms are discussed. Since HCM may precede systemic disease or may often be the first pointer to a triggering agent, further diagnostic procedures are always indicated. Hence, the diagnosis of primary HCM should be made by exclusion.