HYPERTROPHIC CARDIOMYOPATHY WITH OBSTRUCT ION OF THE RIGHT-VENTRICULAR OUTFLOW TRACT IN PRETERM INFANTS UNDER DEXAMETHASONE THERAPY

Dexamethasone is a frequently used drug in the treatment of bronchopul monary dysplasia of preterm infants. Hypertrophic cardiomyopathies wit h obstruction of the left ventricular outflow tract were occasionally observed during this therapy. We treated two preterm infants with seri ous respiratory distress syndrome and intensive mechanical ventilation with dexamethasone shortly after birth. In these two cases the echoca rdiographic findings revealed hypertrophic cardiomyopathies obstructin g the right ventricular outflow tract. After this treatment the abnorm al findings completely disappeared. Clinically the symptoms cannot be clearly distinguished from those of a patent ductus arteriosus with in creasing clinical relevance. In conclusion echocardiographic examinati ons of preterm infants during treatment with dexamethasone are strongl y recommended. If heart murmurs occur this should be done immediately.