Secondary Cardiomyopathy Due to Selenium Deficiency: Multidimensional Cardiac Evaluation and Treatment.

BACKGROUND

Selenium deficiency can cause cardiomyopathy; however, the underlying mechanisms remain unclear. We report a case of cardiomyopathy associated with selenium deficiency in a patient with long-term enteral nutrition.

CASE SUMMARY: A 2-year-old boy with gastrointestinal allergy developed secondary cardiomyopathy due to selenium deficiency resulting from an elemental diet. He presented with reduced left ventricular function and dilated ventricles. Serum selenium levels were undetectable. Myocardial scintigraphy showed perfusion-metabolism mismatches and fibrosis. Selenium supplementation and medications for heart failure led to significant cardiac recovery over a period of 1 year.

DISCUSSION: The patient's congenital heart disease allowed for evaluation before the onset of selenium deficiency cardiomyopathy. Myocardial scintigraphy revealed a characteristic perfusion-metabolism imbalance. Both selenium supplementation and treatment for ischemic heart disease were effective in improving cardiac function.

TAKE-HOME MESSAGES: Myocardial scintigraphy is useful in diagnosing selenium deficiency cardiomyopathy. Selenium supplementation and management of ischemic heart disease are essential for treatment.