Cardiomegaly -Pediatric Oncall

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Gurmeet Singh, Reena Sood Department of Pediatrics and Department of Obstetrics and Gynaecology, Sh...

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Question
4 month baby admitted with excessive crying which resolved in 2 hours .as a part of investigation xray was done which showed cardiomegaly(ct ratio 80%).The Treating physician considered possibility of dilated cardiomyopathy just because of cardiomyopathy after 2 hours of admission patient was asumptomatic. o/e no murmur no other significant finding .Then 2D ECHO was done which was absolutely normal. Still the physician insisted that it is dilated cardiomyopathy and started on carvedilol and digoxin. Is it rational?
Answer
Since the echo is not showing any cardiomegaly, pericardial effusion or cadriac dysfunction, one would have to recheck the Xray. If it is an expiratory film, it is not possible to comment on the CTR. Also is is superior mediastinal widening or the thymic shadow? A lateral xray would be useful. There is no need to start any treatment till the diagnosis is confirmed. Back to All Questions

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