Balancing arrhythmia and hypertension control while avoiding fluid overload in a neonate with hypertrophic heart disease and hyperinsulinism

Managing arrhythmias and hypertension in neonates with structural abnormalities and metabolic disorders is a significant clinical challenge. This case report illustrates the complex intersection of arrhythmogenic events, structural abnormalities and metabolic instability due to congenital hyperinsulinism in a neonate.

Dr Femi Adeniyi
Consultant Neonatologist
femi.adeniyi@nhs.net

Dr Youstina Dawood
Paediatric Registrar

Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust

Adeniyi F., Dawood Y. Balancing arrhythmia and hypertension control while avoiding fluid overload in a neonate with hypertrophic heart disease and congenital hyperinsulinism. Infant 2025; 21(4): 110-11.

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Keywords

arrhythmia; hypertension; metabolic disorders; congenital hyperinsulinism; hypoglycaemia

Key points

Managing arrhythmias and hypertension in infants with structural abnormalities is a delicate process.
Collaborative team management within a tertiary neonatal intensive care setting is essential.

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VOLUME 20 ISSUE 5/SEPTEMBER 2024

Congenital intrahepatic portosystemic shunt and neonatal hyperinsulinaemic hypoglycaemia

An incidental finding of a congenital intrahepatic portosystemic shunt (CPSS) on an abdominal ultrasound scan identified the cause of neonatal hyperinsulinaemic hypoglycaemia (HH). We present the development of clinical presentation, differential diagnosis and subsequent management of a case of CPSS. We provide an explanatory illustration of the pathophysiology of CPSS and HH, highlighting the importance of long-term follow-up of infants who suffer HH early in life.