Background Hypertrophic cardiomyopathy (HCM) in newborns is a rare and pathological condition with heterogeneous etiologies. Among all the different causes of HCM, hyperinsulinism is not generally reported but the relationship between hyperinsulinism and cardiac hypertrophy (CH) is known.
Case presentation We report the case of cardiac hypertrophy (CH) in an Extremely Low Birth Weight (ELBW) infant who underwent insulin therapy after the onset of a persistent hyperglycemia due to parenteral nutrition (PN); the finding supports the hypothesis of a newborn’s iatrogenic hyperinsulinemia in cardiac involvement. Despite the effects of hyperglycemia on myocardial cells are well known and infants of diabetic mother may develop cardiac malformations, the consequences of an early administration of insulin in preterm infants have never been fully clarified and are often underestimated. The present case underlines the importance of a close cardiological follow-up in infants undergoing insulin infusion for an alteration in the glucose metabolism PN-related, that is a common finding in preterm infants.
Conclusion: This case report, also considering the scientific literature, reiterates the importance of taking into account hyperinsulinism in the differential diagnosis of cardiac hypertrophy.