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Transient hypertrophic cardiomyopathy and hypertension associated with hydrocortisone in preterm infant: A case

Jingbo Jiang1, Jiawen Zhang2, Mengmeng Kang2

  • 1Department of Neonatology, Shenzhen Children's Hospital, Shenzhen.

Medicine
|August 16, 2019
PubMed

Insights

Corticosteroid treatment in preterm infants can cause hypertrophic cardiomyopathy (HCM). This case shows reversible cardiac changes in a neonate after hydrocortisone, highlighting the need for careful monitoring.

Area of Science:

  • Neonatal cardiology
  • Pediatric pharmacology
  • Cardiovascular research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a heart muscle disorder often linked to genetics or neuromuscular conditions.
  • In neonates, particularly preterm infants, HCM can be a secondary effect of corticosteroid therapy.

Observation:

  • A 34-week preterm infant developed severe cardiomegaly and a heart murmur after receiving multiple hydrocortisone doses for septic shock and persistent pulmonary hypertension.
  • Echocardiography revealed significant interventricular septum thickening (13.8 mm) and mild posterior left ventricular wall thickening.

Findings:

  • The infant received propranolol and captopril, along with NICU supportive care and Holter monitoring.
  • Cardiac function improved, showing a reversible course without left ventricular outflow tract obstruction or arrhythmias within four weeks.

Implications:

  • Careful consideration of the risk/benefit ratio is crucial when administering corticosteroids to preterm infants.
  • Cardiovascular monitoring using echocardiography and electrocardiography is essential for managing potential cardiac complications.
  • Further research is needed to systematically assess the incidence of cardiac issues in preterm infants treated with corticosteroids.
Abstract

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