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Neonatal hypertension and cardiac failure
K C Hawkins1, A R Watson, N Rutter
1Neonatal Unit, City Hospital, NHS Trust, Nottingham, UK.
Insights
Severe hypertension caused cardiac failure in two newborns. Renal abnormalities were identified, and infants became normotensive post-treatment, suggesting a renovascular origin for infant hypertension and heart failure.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Neonatology
Background:
- Neonatal cardiac failure can present with diverse etiologies.
- Hypertension in neonates is less commonly associated with cardiac failure than hypotension.
Observation:
- Two newborn infants presented with cardiac failure secondary to severe hypertension.
- Cardiac dysfunction resolved with treatment of hypertension.
- Both infants exhibited renal abnormalities and were normotensive at 18 months follow-up.
Findings:
- The study identified a link between severe hypertension and cardiac failure in neonates.
- Renal abnormalities were consistently present in affected infants.
- Resolution of hypertension led to normalization of cardiac function.
Implications:
- Elevated blood pressure should be considered in neonates with cardiac failure, especially when primary cardiac pathology is absent.
- Renal or renovascular causes should be investigated in infants presenting with unexplained hypertension and cardiac compromise.
- Early identification and management of renovascular hypertension can prevent long-term cardiac sequelae in neonates.
Abstract:
Two newborn infants developed cardiac failure due to severe hypertension which was recognised as the heart failure was treated. Renal abnormalities were found in both infants who are normotensive off treatment at 18 months follow up. The finding of hypertension rather than hypotension in the presence of cardiac failure and the apparent absence of a cardiac abnormality should prompt a search for a renal or renovascular cause.