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Case Reports
. 2021 Sep 30;47(1):197.
doi: 10.1186/s13052-021-01145-x.

Hypertrophic cardiomyopathy in infant newborns of diabetic mother: a heterogeneous condition, the importance of anamnesis, physical examination and follow-up

Alessia Claudia Codazzi  1 , Rosario Ippolito  2 , Cecilia Novara  3 , Enrico Tondina  3 , Rosa Maria Cerbo  4 , Chryssoula Tzialla  4
Affiliations
Case Reports

Hypertrophic cardiomyopathy in infant newborns of diabetic mother: a heterogeneous condition, the importance of anamnesis, physical examination and follow-up

Alessia Claudia Codazzi et al. Ital J Pediatr. .

Abstract

Background: Hypertrophic cardiomyopathy (HCM) in neonates is a rare and heterogeneous disorder. HCM accounts for 25 to 40% of all pediatric cardiomyopathy cases and the highest incidence in pediatric population is reported in children < 1 year.

Case presentation: we report two clinical cases of neonates, born to mothers respectively with a pre-pregnancy insulin-dependent diabetic mellitus type 2 and a suspected diabetes, with inadequate prenatal glycemic control for the first and underestimated glycemic control for the second case, with a different evolution. In the first case, a slow evidence of improvement of the HCM was observed, persuading us to the diagnosis of a diabetes-related HCM; In the second case the progressive worsening of the HCM during follow-up in association with further investigations, resulted in the diagnosis of Pompe disease.

Conclusions: Hypertrophic cardiomyopathy in newborns can be the clinical expression of different underlying disorders. We aim to show the importance both to reassess maternal and family history and critically evaluate the physical examination in order to address the correct differential diagnosis. Furthermore it is important to continue a regular cardiologic follow-up for this pathology with neonatal onset to prevent a poor prognosis.

Keywords: Fetal hyperinsulinemia; Interventricular septal hypertrophy; Pompe disease.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Echocardiogram performed after birth showed severe Left Ventricular (LV) hypertrophy and interventricular septal hypertrophy (IVSd of 15.9 mm, z-score 6.81) with a significant reduction in the ventricular cavity
Fig. 2
Fig. 2
Echocardiogram performed (6 months of age) showed a significant reduction of the interventricular septal hypertrophy (IVSd of 8 mm; z-score 3.01)
Fig. 3
Fig. 3
ECG: high voltage QRS complexes in precordial leads and a short PR interval
Fig. 4
Fig. 4
Echocardiogram performed (3 months of age) showed an interventricular septal hypertrophy (SIVd 11.2 mm; z-score 5.1) and a significant reduction in left ventricular cavity (EDV 5 ml) with ecocardiographic signs of LV outflow tract obstruction (maximum intraventricular pressure gradient 7.9 mmHg)
See this image and copyright information in PMC

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