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Fetal hypertrophic cardiomyopathy - maternal diabetes-induced

Case contributed by Francis Fortin
Diagnosis almost certain

Presentation

Maternal diabetes. Known fetal hypertrophic cardiomyopathy by prior ultrasounds (not shown). Evaluate abdomen and rule-out testicular torsion (bluish scrotal discoloration).

Patient Data

Age: Newborn, day 0
Gender: Male

Collages of ultrasound images show marked hypertrophy of both ventricular walls, predominantly affecting the interventricular septum which was measured at 1.5 cm. This was known by prior gestational ultrasounds (not shown).

The liver is hyperechogenic and enlarged, presumably due to congestion secondary to heart failure. The testicles are normally positioned and vascularized, but there are bilateral hydroceles.

Case Discussion

Subsequent dedicated cardiac ultrasound by a pediatric cardiologist confirmed a septal-predominant obstructive hypertrophic cardiomyopathy. Due to the known association with fetal hypertrophic cardiomyopathy, the etiology was attributed to the mother's known diabetes throughout pregnancy.

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