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Infantile Hemangioma and Cardiac Defects: a Puzzling Association. A Single-center Experience
Andrea Bassi1, Andrea Azzarelli2, Angelina Vaccaro3
1Dermatology Unit, Azienda Toscana Nord Ovest, Lucca, Italy.
Insights
Infantile hemangioma patients show a higher rate of cardiac abnormalities, particularly interatrial septal defects, before propranolol therapy. Further research is needed to understand the full implications and potential effects of propranolol on these findings.
Area of Science:
- Pediatric Cardiology
- Dermatology
- Medical Genetics
Background:
- Infantile hemangioma (IH) is a common vascular tumor in infants.
- Some studies suggest a higher prevalence of cardiac abnormalities in infants with IH, especially those treated with propranolol.
- Cardiologic evaluation before propranolol therapy is crucial for this patient group.
Purpose of the Study:
- To evaluate the clinical charts of patients with infantile hemangioma (IH) who underwent cardiologic evaluation before propranolol therapy.
- To compare the prevalence of cardiac findings in IH patients with existing literature data.
- To identify specific cardiac abnormalities in IH patients.
Main Methods:
- Retrospective review of clinical charts of infants with IH from 2016 to 2021.
- Inclusion of patients who underwent pediatric cardiology screening before initiating propranolol therapy.
- Analysis of electrocardiogram (ECG) and echocardiogram data.
Main Results:
- 60 infants with IH were analyzed; 50 underwent echocardiography.
- ECG revealed abnormalities in only 3.3% of patients.
- Echocardiograms showed findings in 51.7% of patients, with interatrial septal defects being the most common pathological finding (30%).
Conclusions:
- Patients with infantile hemangioma exhibit a higher incidence of cardiologic findings before propranolol treatment compared to healthy newborns.
- Interatrial septal defects are the most frequent pathological cardiac finding in this cohort.
- Further large-scale prospective studies are recommended to elucidate the association between IH, cardiac defects, and propranolol therapy.
Objectives:
to evaluate clinical chart of patients with IH who had cardiologic evaluation before propranolol therapy and to compare our findings with literature data.
Introduction:
Some studies have assessed the incidence of heart defects in children suffering from infantile hemangioma (IH) treated with propranolol, showing a possible higher prevalence of cardiac abnormalities in this group of patients.
Methods:
We retrospectively reviewed clinical charts of children with infantile hemangiomas referred to our dermatologic division from 2016 to 2021, who underwent our pediatric cardiology protocol screening before starting propranolol therapy.
Results:
A total of 60 infants were enrolled. Electrocardiograms were available for all the patients and echocardiography for 50/60 (83.3%) children. Electrocardiogram didn't reveal any alterations in most cases (pathologic in 2/60 ones, 3.3%) while echocardiograms revealed findings in 31/50 (51.7%) patients. Of these, persistent foramenovale, which was found in 14/50 patients (28%), was considered as non-pathologic. Interatrial septal defects were the main pathological finding in 15/50 patients (30%), as single defect or in association with other abnormalities.
Conclusions:
Our study confirms the presence of a higher rate of cardiologic findings in patients with infantile hemangioma evaluated before starting oral propranolol, compared to the known rate of those defects in healthy newborns. We also confirm that interatrial septal defects are the most frequent pathologic finding with a higher prevalence compared to published studies. Large prospective studies are needed to clarify a possible association of pathological cardiac findings in all patients with infantile hemangiomas and thereafter to evaluate the possible effect of propranolol therapy on these defects during time.
