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Hypertrophic obstructive cardiomyopathy as a side effect of dexamethasone treatment for bronchopulmonary dysplasia
P L Brand1, R A van Lingen, F Brus
1Division of Neonatology and Pediatric Cardiology, Beatrix' Children's Clinic, University Hospital, Groningen, The Netherlands.
Insights
Dexamethasone treatment for bronchopulmonary dysplasia may cause hypertrophic obstructive cardiomyopathy in infants. This heart condition resolved after stopping the steroid medication, suggesting a direct link.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Dexamethasone, a corticosteroid, is sometimes used to treat BPD.
- Cardiac function is typically monitored in infants with BPD.
Observation:
- Three infants with BPD received dexamethasone therapy.
- No cardiac abnormalities were detected before dexamethasone treatment.
- Hypertrophic obstructive cardiomyopathy (HOCM) developed during dexamethasone treatment in all three infants.
Findings:
- HOCM appeared and progressed during dexamethasone therapy.
- HOCM resolved completely after dexamethasone cessation.
- A potential causative association between dexamethasone and HOCM is suggested.
Implications:
- This finding highlights a potential adverse effect of dexamethasone in infants.
- Clinicians should be aware of the risk of HOCM with dexamethasone use in BPD.
- Further research is needed to understand the mechanism of dexamethasone-induced HOCM.
Abstract:
We report three infants who developed hypertrophic obstructive cardiomyopathy during dexamethasone treatment for bronchopulmonary dysplasia. In all three infants, echocardiography had ruled out cardiac abnormalities prior to the dexamethasone course. The hypertrophic obstructive cardiomyopathy appeared and progressed during dexamethasone therapy and resolved completely after its cessation. This suggests a causative association between the hypertrophic obstructive cardiomyopathy and the exogenous glucocorticosteroid therapy. The mechanism of this dexamethasone-related hypertrophic obstructive cardiomyopathy is unclear. This complication may be encountered more frequently with the increasing use of dexamethasone in infants with bronchopulmonary dysplasia.