Left ventricular hypertrophy with outflow tract obstruction-a complication of dexamethasone treatment for subglottic stenosis.
To our knowledge, this is the 1st reported case of steroid-induced obstructive cardiomyopathy in a child being treated for subglottic stenosis. As well, although born at 27 weeks, our patient was over 4 kg and 4 months of age (44 weeks corrected gestational age). This appears to be a phenomenon chiefly involving premature babies in the neonatal period with no reports of this occurring in patients greater than 40 weeks corrected gestational age. Signs of cardiac hypertrophy include tachycardia, new cardiac murmur, increased oxygen requirements, decreased urine output, and decreased peripheral perfusion. Diagnosis and eventual recovery was confirmed with serial echocardiograms. Knowledge of this serious side effect of dexamethasone will allow otolaryngologists to intervene early and prevent a potentially deadly complication.
Balys
Rick
R
McGill University, Department of Otolaryngology, Montreal Children's Hospital, Montreal, Canada.
Manoukian
John
J
Zalai
Christian
C
D001999:Bronchoscopy; D002312:Cardiomyopathy, Hypertrophic / Q000139:chemically induced*; D003907:Dexamethasone / Q000009:adverse effects*; D005938:Glucocorticoids / Q000009:adverse effects*; D006102:Granuloma, Laryngeal / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007829:Laryngostenosis / Q000209:etiology / Q000628:therapy*; D008297:Male
D005938:Glucocorticoids; D003907:Dexamethasone