A 7 YEAR OLD CHILD OF A CLOSE FRIEND, WAS RECENTLY DIAGNOSED WITH AN
ENLARGED HEART. THE CHILD WAS GETTING DIZZY, VOMITING AND EVENTUALLY
FAINTING. SHE HAS BEEN ADMITTED TO ST. FRANCIS HOSPITAL IN NEW YORK.
UNFORTUNATELY, THEY HAVE NOT BEEN ABLE TO FIND THE CAUSE OF THE ENLARGED HEART.
SO FAR, ALL TESTS HAVE BEEN NEGATIVE. WHAT COULD BE POSSIBLE CAUSES OF
AN ENLARGED HEART IN SUCH A YOUNG CHILD ? ANY INFORMATION WOULD BE HELPFUL.
THANK YOU.
_
Dear S. Circo, thank you for your question. From your follow-up questions, you
mention that the child you describe was found to have moderate pulmonary hypertension
and no congenital cardiac malformation. Thus, the question now appears to be
what can cause cardiomegaly (an enlarged heart) and pulmonary hypertension (PHTN) in
a child? Most likely, this represents a disorder called primary PHTN where the
pulmonary arteries that bring blood from the right ventricle of the heart to the
lung are abnormal so the pressure within these arteries increases. As the pulmonary
pressure increases, the right ventricle dilates and thus cardiomegaly results.
The cause of primary PHTN in children is unknown and this disorder is usually
treated with blood thinners to prevent clots from forming in the arteries,
vasodilator medications to reduce the pulmonary pressures, and sometimes, inhaled
medications to reduce the pulmonary pressures. However, you did not mention how
the diagnosis of pulmonary hypertension was made. Certain tests that should be
done for this child include an echocardiogram (ultrasound of the heart) to
exclude valvular or congenital heart disease and a right-heart catheterization
to directly measure the pulmonary pressures. With the information provided by
these two tests, an accurate diagnosis can be made. Additionally, the physicians
caring for this child should be able to provide more information on the diagnosis
and prognosis than what you have mentioned. I hope you find this information
useful.
Information provided in the heart forum is for general purposes only.
Specific diagnoses and therapies can only be made by your physician.
