Cardiac Hypertrophy in an Infant of a Diabetic Mother: A Case of Reversible Cardiomyopathy

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disorder characterised by insulin deficiency or resistance and/or β-cell defects. High Body Mass Index (BMI) at conception, undiagnosed pregestational diabetes, and poor glycaemic control significantly affect the foetal heart, foetoplacental circulation and foetal growth. Myocardial hypertrophy and cardiac defects are more prevalent in Infants of Diabetic Mothers (IDMs). Cardiac Hypertrophy (CH) is characterised by a significant thickening of the interventricular septum, reduction in the size of the ventricular cavity, systolic and diastolic dysfunction and subaortic stenosis. A term neonate born to a mother with pregestational insulin-dependent Type I Diabetes Mellitus (T1DM) developed respiratory distress soon after birth, and Echocardiography (ECHO) showed Asymmetric Septal Hypertrophy (ASH) and Left Ventricular Outflow Tract (LVOT) obstruction. The baby responded well to oral propranolol, which was continued for four weeks, resulting in the resolution of CH at four months of age on follow-up. The present case underscores the importance of ECHO, even in infants born to mothers with good glycaemic control.

Keywords

• cardiomegaly
• diabetes
• hyperinsulinaemia
• macrosomia
• propranolol