Neonatal cardiomyopathy

Case contributed by Dr Jeremy Jones

Presentation

38/40 neonate. Normal pregnancy and antenatal ultrasound. Respiratory distress.

Patient Data

Age: 4 days
Gender: Male
X-ray

Intubated neonate with no humeral head ossification.  NG tube in the stomach.  UVC line tup looped in the region of the porta hepatis with the tip likely lying in the portal vein.

The cardiac contour is massively widened with a CTR over 80%. Despite cardiomegaly, there is no pulmonary venous prominence, air-space consolidation, interstitial fluid or pleural effusion.

Case Discussion

The picture here is of massive cardiomegaly in a term neonate with respiratory distress, but no evidence of overload (no alveolar or interstitial oedema, or pleural effusion).

While the vast majority of neonates with this degree of cardiomegaly, will have a structural cardiac defect, the lack of secondary signs point to a narrower differential that includes neonatal cardiomyopathy.

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Case information

rID: 23833
Case created: 12th Jul 2013
Last edited: 15th Oct 2015
Inclusion in quiz mode: Included

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