Cardiomegaly in Association With Neonatal Hypoglycaemia

Abstract

Summary Fifty‐two infants with hypoglycaemia were seen over a 12 month period. Six of these infants had cardiac enlargement with signs of failure and pulmonary oedema in association with isolated hypoglycaemia. Signs and symptoms suggestive of cardiac failure corresponded to the period of hypoglycaemia and disappeared when blood sugar levels were raised by appropriate treatment.

Heart Failure and Neonatal Hypocalcaemia

“…Acidosis in the neonatal period is said to cause cardiac embarrassment (Rowe and Mehrizi, 1968), but none of the infants was acidotic before the onset of heart failure. Hypoglycaemia has been reported in association with heart failure (Amatayakul et al, 1970;Reid et al, 1971), but blood glucose estimations were performed in three of the present cases and were normal. None of the infants had high haematocrit readings, and none of the mothers were known to have diabetes (Craig, 1958).…”

Congenital paroxysmal atrial tachycardia.

“…Transient symptomatic neonatal hypoglycaemia, whose reported incidence is 1 * 3-2 * 9 per 1000 births, is usually found in infants of low birthweight for their period of gestation, and thA pathogenesis is thought to be linked with intrauterine undernutrition (Cornblath and Schwartz 1966). A relation between cardiac failure and neonatal hypoglycaemia has been documented by Reid et al (1971), and 2 of our 3 patients with known hypoglycaemia had severe cardiac failure. (In fact 8 were considered to be in cardiac failure, but the lack of glucose values in all patients precludes definition of a relation in this series.)…”

Nonstructural heart disease in the newborn. Observations during one year in a perinatal service.

“…Perhaps the infant with hydrops is a reasonably simple diagnostic problem but for few of the others does the aetiology emerge easily. The association of congenital heart disease and nonstructural heart disease in infants of diabetic mothers makes the need for strenuous and complete diagnostic assessment mandatory in this group of patients (Keith et al, 1961;Rowland et al, 1973;Poland et al, 1975;Wolfe and Way, 1977), particularly when cardiac dilatation is associated with hypoglycaemia (Reid et al, 1971).…”