Hypertrophic Obstructive Cardiomyopathy in an Infant of a Diabetic Mother

Robinson, Brad; Eshaghpour, Eshagh; Ewing, Stanford; Baumgart, Stephen

doi:10.1097/00002480-199811000-00015

Cited by 15 publications

(4 citation statements)

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“…Management of CH in very preterm infants is not well-established and consists, as with term infants, of supportive therapy, increased intravenous fluid administration [ 15 ], and/or propranolol or other β-blocker treatment [ 2 , 7 , 8 ], on the basis of patient’s clinical status and echocardiographic findings. However, our case series and the previous case report [ 7 ] suggest that CH spontaneously resolves at a later time in most patients without a specific treatment, and it is possible that a resolution occurs in all surviving patients.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

et al. 2023

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Background In the neonatal period, cardiac hypertrophy (CH) has been commonly associated with hyperinsulinemic pathologies, and the first case of CH in an extremely preterm infant treated with insulin infusion has recently been reported. To confirm this association, we report a case series of patients who developed CH after insulin therapy. Methods Infants with gestational age < 30 weeks and birth weight < 1500 g, born from November 2017 to June 2022, were studied if they developed hyperglycemia requiring treatment with insulin and had echocardiographic diagnosis of CH. Results We studied 10 extremely preterm infants (24.3 ± 1.4 weeks) who developed CH at a mean age of 124 ± 37 h of life, 98 ± 24 h after the initiation of insulin therapy. All surviving patients had resolution of CH at discharge, while three of four (75%) of the deceased patients had persistent CH. Conclusions Our case series supports the association between the development of CH and insulin therapy in extremely preterm infants and suggests further caution and the need for echocardiographic monitoring when treating these fragile patients with insulin.

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Section: Discussionmentioning

confidence: 99%

“…Management of infants with CH included careful echocardiographic follow-up and, in symptomatic infants, supportive therapy (i.e., non-invasive and invasive respiratory support), increased intravenous fluid administration [ 15 ], and/or propranolol or other β-blockers to improve cardiac output [ 2 , 7 , 8 ], as required.…”

Section: Methodsmentioning

confidence: 99%

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

et al. 2023

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“…While HCM in babies of diabetic mothers is usually mild and reversible, it is rarely severe leading to fetal or neonatal death. Only five patients with severe neonatal HCM were reported previously in association with GDM [2, 3, 9–11]. Other studies showed that glucose and insulin levels were not so predictive of fetal macrosomia [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series

et al. 2017

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BackgroundMacrosomia and hypertrophic cardiomyopathy are two features often associated in neonates of diabetic mothers. We report the cases of three patients with severe macrosomia and critical hypertrophic cardiomyopathy without severely unbalanced maternal diabetes. Only three patients with those two features and no uncontrolled maternal diabetes have been previously reported.Case presentationThe first patient was a 39-week-old girl, the second patient was a 39-week-old girl, and the third patient was a 41-week-old boy. The two French girls and the French boy had severe macrosomia and hypertrophic cardiomyopathy, leading to the death of the boy. The outcome of the two girls was favorable, with a standardization of growth curves and ventricular hypertrophy. Their mothers presented with high body mass index but no severe documented maternal diabetes; glycemic imbalance was only suspected on postnatal analyses. There was no hydramnios during pregnancy and no other environmental factor, especially toxic exposure. Their parents are from Mayotte, Guadeloupe, and Guinea-Conakry. The usual genetics causes, Beckwith–Wiedemann syndrome, and chromosomal copy number variation, were also excluded.ConclusionsThis report suggests the implication of other factors in addition to glycemic disorders, including genetic factors, in the occurrence of macrosomia and severe hypertrophic cardiomyopathy in neonates. These three original observations indicate that gynecologists and neonatologists should pay attention to neonates from mothers with a high body mass index and when maternal diabetes is not documented.Electronic supplementary materialThe online version of this article (doi:10.1186/s13256-017-1231-5) contains supplementary material, which is available to authorized users.

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“…Antiarrhythmic Agents. Published case reports suggest higher doses of both esmolol and amiodarone may be required while on ECMO but no firm conclusions can be made [92,93].…”

Section: Cardiovascular Medicationsmentioning

confidence: 99%

Pharmacotherapy during pediatric extracorporeal membrane oxygenation: a review

Himebauch

Kilbaugh

Zuppa

2016

Expert Opinion on Drug Metabolism & Toxicology

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Clinicians caring for pediatric patients treated with ECMO must have an understanding of PK alterations that could lead to either therapeutic failures or increased drug toxicity during this life-saving therapy. Limited data currently exist for optimal drug dosing in pediatric populations who are treated with ECMO. While there are clear challenges to conducting and analyzing data associated with clinical pharmacokinetic-pharmacodynamic studies of children on ECMO, we present techniques to address these challenges. Improved understanding of the physiology and drug disposition during ECMO combined with PK-PD modeling will allow for more adaptable and individualized dosing schemes.

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Hypertrophic Obstructive Cardiomyopathy in an Infant of a Diabetic Mother

Cited by 15 publications

References 0 publications

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series

Pharmacotherapy during pediatric extracorporeal membrane oxygenation: a review

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