Cardiomyopathy and improving ef values

[xtrasalt]

We are in the process of reviewing an adoption of a 6 year old Thai girl. Her medical lists seven hospitalizations for pneumonia from 2002 to 2003 and dilated cardiomyopathy. She is experiencing no shortness of breath nor edema and her last med 8/2005 showed “improvement – no clinical heart failure – normal left ventricular function.” She was on Lasix syrup, lanoxin syrup, enarapril and alductone, from 10/2003 to 8/2005 and then was removed from all meds. Her EF was 20% 10/03, then 20% 11/03 and then rose to 58% in 8/05! She also has an elevated LDH of 358 with all other blood test being normal. She also is reported to have no heart murmur.

Is this change in EF “normal” or possible for a diagnosis of dilated cardiomyopathy? Is it possible that the pneumonia or an infection may have caused the cardiomyopathy? She is such a sweet girl and my wife and I just want to have some idea of her prognosis. We understand that this is not a diagnosis and will be pursuing a full medical consult shortly!

Thanks

Chuck

[Cleveland Clinic]

xtrasalt,

I rally have no idea without being able to review her full history and even then, the answer would be better posed to a pediatric cardiologist. There are some cardiomyopathies that can arise from myocarditis that may be self limited and some that are inherited that present early in life. The latter would probably be more likely to recur/progress.


This is a big step you are taking. Seeking a specialist in pediatric cardiology would be very helpful.

good luck

[EchoTech]

The short answer is yes.  It doesn't happen a lot, but it does happen and the girl is lucky enough to have a second chance.  Hopefully she won't have any use for a pediatric cardiologist after her initial visit.

In adults it can happen too, but it seems more rare in my andectdotal experience.