Case Report

Pathological left ventricular hypertrophy and outflow tract obstruction in an infant of a diabetic mother: A case report

Ujuanbi AS*, Onyeka CA, Yeibake WS, Oremodu T, Kunle-Olowu OE and Otaigbe BE

Published: 03 March, 2020 | Volume 5 - Issue 1 | Pages: 047-050

Background: Infants of diabetic mothers (IDMs) are at increased risk of developing congenital anomalies including cardiac defects. Pathological left ventricular hypertrophy, asymmetrical septal hypertrophy and outflow tract obstruction is a rare but known cardiac comorbidity in infants of diabetic mothers. The severity of this condition in IDMs can vary from an incidental finding on echocardiography to an infant with severe symptoms of congestive heart failure and specific management of the condition varies.

Aim: The aim of this article is to report this clinical entity in a Nigerian infant born to a mother with poor glycaemic control in pregnancy and highlight management.

Case report: We report a term neonate who was diagnosed as a case of pathological left ventricular hypertrophy, asymmetrical septal hypertrophy and outflow tract obstruction delivered to a mother with gestational diabetics with poor glycaemic control in pregnancy. Child was treated successfully with β-adrenergic blocker and showed resolution of hypertrophy in follow-up echocardiography.

Conclusion: Infants of diabetic mothers are very high risk infants. Pathological left ventricular hypertrophy in IDM have good prognosis. Early recognition and prompt intervention is advocated.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001085 Cite this Article Read Full Article PDF


Pathological left ventricular hypertrophy; Outflow tract obstruction; Infant of diabetic mother


  1. Venkat Rk, Aakash P, Anish P. Infant of diabetic mother: what one needs to know? J Matern Fetal Neonatal Med. 2020; 33: 482-492. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29947269
  2. Sharma D, Pandita A, Shastri S, Sharma P. Asymmetrical septal hypertrophy and hypertrophic cardiomyopathy infant of diabetic mother: a reversible cardiomyopathy. Med J. 2016; 9: 257-260.
  3. Buchanan TA, Kitzmiller JL. Metabolic interactions of diabetes and pregnancy. Annu Rev Med. 1994; 45: 245-260. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8198381
  4. Russell NE, Holloway P, Quinn S, Foley M, Kelehan P, et al. Cardiomyopathy and cardiomegaly in stillborn infants of diabetic mothers. Pediatr Dev Pathol. 2008; 11: 10-14. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18237240
  5. Demiroren K, Cam L, Oran B, Koç H, Başpinar O, et al. Echocardiographic measure-ments in infants of diabetic mothers and macrosomic infants of nondiabetic mothers. J Perinat Med. 2005; 33: 232-235. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15914346
  6. Park MK. Pediatric cardiology. 4th ed. St. Louis: Mosby; 2002. Primary myocardial disease. 2002; 267-392.
  7. Ullmo S, Vial Y, Di Bernardo S, Roth-Kleiner M, Mivelaz Y, et al. Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study. Eur Heart J. 2007; 28: 1319–1325. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17158827
  8. Hay WW. Care of the infant of the diabetic mother. Curr Diab Rep. 2012; 12: 4–15. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22094826
  9. Reller MD, Kaplan S. Hypertrophic cardiomyopathy in infants of diabetic mothers: an update. Am J Perinatol. 1988; 5: 353-358. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2971360
  10. Way GL, Wolfe RR, Eshaghpour E, Bender RL, Jaffe RB, et al. The natural history of hypertrophic cardiomyopathy in infants of diabetic mothers. J Pediatr. 1979; 95: 1020-1025. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/159352
  11. Goodwin JF. A current appraisal of the cardiomyopathies. Hosp Update. 1979; 5: 665-683
  12. Poland R L, Walther LJ, Chang L. Hypertrophic cardiomyopathy in infants of diabetic mothers (abstract). Pediatr Res. 1975; 9: 269.
  13. Way GL, Ruttenberg HD, Eshaghpour E, Nora JJ, Wolfe RE. Hypertrophic obstructive cardiomyopathy in infants of diabetic mothers (abstract). Circulation. 1976; 53-54.
  14. Gutgesell HP, Mullins CE, Gillette PC, Speer M, Rudolph AJ, et al. Transient hypertrophic subaortic stenosis in infants of diabetic mothers. J Pediatr. 1976; 89: 120-125. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/945337
  15. Maron BJ, Edwards JE, Henry WL, Clark CE, Bingle GJ, et al. Asymmetric septal hypertrophy (ASH) in infancy. Circulation. 1974; 50: 809-820. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/4278818
  16. Halliday HL. Hypertrophic cardiomyopathy in infants of poor1y-controlled diabetic mothers. Arch Dis Childhood. 1981; 56: 258-263.
  17. Howard PG, Michael ES, Harvey SR. Characterization of the Cardiomyopathy in Infants of Diabetic Mothers. Circulation. 1980; 61: 441-450. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6444280
  18. Bulkley BH, Weisfeldt ML, Hutchins GM. Isometric cardiac contraction. a possible cause of the disorganized myocardial pattern of idiopathic hypertrophic subaortic stenosis. N Engl J Med. 1977; 296: 135-139. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/556638
  19. Denfield SW, Gajarski RJ, Towbin JA. Cardiomyopathies. In: Garson AG, Bricker JT, Fisher DJ, Neish SR, editors. The Science and Practice of Pediatric Cardiology. 1998; 1851.


Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?