A Case of Cardiomyopathy Due to Premature Ductus Arteriosus Closure: The Flip Side of Paracetamol

Pediatrics. 2018 Feb;141(2):e20163850. doi: 10.1542/peds.2016-3850. Epub 2018 Jan 17.

Abstract

Paracetamol (acetaminophen or N-acetyl-p-aminophenol) is considered a safe analgesic and antipyretic nonsteroidal antiinflammatory drug commonly used during pediatric ages and during pregnancy. We report on a term neonate with closed ductus arteriosus, severe cardiomyopathy, right ventricular dysfunction, and functional stenosis of pulmonary arteries at birth after maternal self-medication with paracetamol and consumption of polyphenol-rich foods in late pregnancy. This drug, especially when associated with other vasoconstrictors (such as polyphenols), interferes with prostaglandin metabolism, which seriously accentuates the intrauterine ductus arteriosus constriction and leads to pharmacologic adverse events. We suggest maternal educational programs to avoid risky self-medications and provide training for the best diets.

Publication types

  • Case Reports

MeSH terms

  • Acetaminophen / adverse effects*
  • Analgesics, Non-Narcotic / adverse effects*
  • Cardiomyopathies / chemically induced*
  • Diet, Mediterranean / adverse effects
  • Ductus Arteriosus / drug effects*
  • Female
  • Heart Murmurs / chemically induced
  • Humans
  • Infant, Newborn
  • Polyphenols / adverse effects
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Pulmonary Valve Stenosis / chemically induced
  • Self Medication
  • Vasoconstrictor Agents / adverse effects
  • Ventricular Dysfunction, Right / chemically induced*

Substances

  • Analgesics, Non-Narcotic
  • Polyphenols
  • Vasoconstrictor Agents
  • Acetaminophen