Malnutrition‐related cardiomyopathy in a pediatric patient with autism spectrum disorder

We present a case of a 5‐year‐old male patient with history of autism spectrum disorder and chronic malnutrition secondary to an extremely restrictive diet who presented with life‐threatening anemia and heart failure secondary to malnutrition‐related cardiomyopathy. This case highlights the importance of recognizing nutritional deficiencies in high‐risk individuals and screening for nutritional deficiencies in at‐risk children. Furthermore, it underscores the need for early recognition and intervention as malnutrition‐related cardiomyopathy can have significant morbidity. Clinical Presentation – a pediatric patient with autism spectrum disorder and subsequent chronic malnutrition presented with symptoms of anemia and heart failure. Underlying Cause – the diagnosis of malnutrition‐related cardiomyopathy was linked to the patient's severely restrictive diet stemming from their underlying autism spectrum disorder. Diagnostic Findings – echocardiogram revealed severe left ventricular dilation with dysfunction and a severely dilated left atrium consistent with cardiomyopathy. Labs showed severe anemia and hypoalbuminemia. Management – multidisciplinary intervention included cardiac support with diuretics and inotropes alongside nutritional rehabilitation including micronutrient supplementation, parenteral nutrition support and eventual enteral feeding. Outcome – significant improvement in cardiac function and nutritional status was achieved after tailored interventions. Clinical Implications – this case emphasizes the importance of early recognition and prompt intervention on malnutrition‐related cardiomyopathy in children with autism spectrum disorder, where dietary limitations may have severe clinical consequences.