Cardiac Hypertrophy in Newborn Infants *

The subject of cardiac hypertrophy unassociated with congenital malformation of the heart or great vessels in newborn infants has received scant attention. Although many text-books on pediatrics have been consulted, only one reference to the condition was found and that was by Von Reuss."1 He described a single case briefly and stated that the etiology was unknown. Recent studies indicate, however, that a considerable increase in the size and weight of the heart may be present at birth in certain conditions. Miller and Wilson have observed, by means of roentgenograms, a temporary but marked enlargement of the heart in infants born to mothers with diabetes mellitus.9 The enlargement of the heart in these infants is present at birth and disappears, so far as is known, by the. end of the second month of life. Post-mortem studies of the hearts of these infants indicate that the cardiac enlargement is an actual hypertrophy in the sense that the organ has an increased weight in about 50 per cent of the fatal cases.9 Cardiac hypertrophy has also been recognized in the post-mortem studies made on newborn infants dying with erythroblastosis fetalis and hydrops fetalis by Diamond, Blackfan, and Baty,3 by Hellman and Hertig,7 and Liebegott.8 These observations raise the question as to whether or not cardiac hypertrophy occurs under other circumstances in the newborn period and, if so, how can it be recognized either clinically or at the autopsy table. The most suitable method at the present time of recognizing and determining the incidence of cardiac hypertrophy is through a study of the weight of the heart obtained at the autopsy table. A heart with an excessive weight can be accepted in a broad sense as a hypertrophied heart. In order to decide whether or not a heart in a given case has an excessive weight, accurate knowledge of the weight of the heart under conditions as normal as possible should be available. Several attempts have been made to determine the weight of the heart of newborn infants. The results of these studies are listed in Table 1. It is apparent from an inspection of the data in the table that the results vary considerably. One example of the difficulty that exists in trying to diagnose cardiac hypertrophy from