High-output heart failure in a newborn.
High-output cardiac failure is rare in newborns. Emergent diagnosis and management of this pathology is crucial. We report the case of a child, currently 12-months old; obstetric background is non-contributory. Clinic observation on D1 was normal except for the presence of a systolic cardiac murmur; cardiological evaluation revealed mild ventricular dysfunction of the right ventricle. On the third day of life, she developed cardiac failure with gallop rhythm, hepatomegaly and a murmur in the anterior fontanel; an echocardiogram confirmed clinic aggravation with biventricular dysfunction and right cavities and superior vena cava dilatation. The cranial MRI confirmed the presence of a pial arteriovenous malformation (AVM) involving the anterior and middle cerebral arteries with an associated fronto-parietal ischaemic lesion. The infant underwent embolisations of AVM with successful flow reduction and cardiac failure improvement. The multidisciplinary follow-up showed no cardiac dysfunction or permanent lesions but confirmed a severe psycho-motor delay and left hemiparesia.
Neonatal Intensive Care Unit, Department of Pediatrics-Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal. ines.mascarenhas@gmail.com
Maria Inês
MI
Mascarenhas
Marta
M
Moniz
Sofia
S
Ferreira
Augusto
A
Goulão
Rosalina
R
Barroso
D002302:Cardiac Output / Q000502:physiology*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D013902:Radiography, Thoracic