Cardiac Recovery and Survival After Neonatal Myocardial Infarction

Abstract

Management of cardiogenic shock following neonatal myocardial infarction (MI) has received little attention in the literature. Advances in medical support have been pharmacologic in nature, yet the outcome remains dismal. We report the course of a neonate after MI. Extracorporeal membrane oxygenation was utilized for hemodynamic support during the immediate post-MI period. The patient initially was in massive cardiogenic shock, but her myocardial function recovered completely. She has a normal neurodevelopmental outcome at 22 months of age.

Functional Recovery of a Human Neonatal Heart After Severe Myocardial Infarction

“…Of note, a few case reports have been published describing patients having MI in the neonatal period without structural heart disease. [26][27][28][29][30][31][32] All reported newborns with documented MI that survived the acute phase apparently recovered their heart function. [26][27][28]31,32 Because reperfusion therapy was successfully performed in our patient, we cannot exclude the phenomena of stunning or hibernation contributing to the profound cardiac improvements in our patient.…”

“…[26][27][28][29][30][31][32] All reported newborns with documented MI that survived the acute phase apparently recovered their heart function. [26][27][28]31,32 Because reperfusion therapy was successfully performed in our patient, we cannot exclude the phenomena of stunning or hibernation contributing to the profound cardiac improvements in our patient. 33 However, delayed thrombolysis, massive release of cardiomyocyte-specific troponin T, indicative of cardiomyocyte necrosis, and ECG-and echocardiographydocumented myocardial damage all clearly indicate that the newborn child had severe MI with subsequent severe structural and functional cardiac impairments.…”

Subendocardial infarction associated with ventricular hypertrophy in preterm infants with chronic lung disease

“…Reported etiologies in these age groups include coronary artery anomaly, coronary thromboembolus, perinatal asphyxia, aortic stenosis, coarctation of the aorta and myocarditis. [1][2][3] We describe here three preterm neonates with bronchopulmonary dysplasia (BPD) and pulmonary hypertension who incurred subendocardial infarctions in association with ventricular hypertrophy.…”

Avaliação ecocardiográfica evolutiva do infarto do miocárdio em ratos jovens e adultos

“…The clinical evolution of adult and pediatric patients with ventricular dysfunction due to myocardial ischemic disease shows to be distinct, as well as its etiologies 1,2 . Among adults with myocardial infarction (MI) submitted to coronary artery reperfusion, only a small number of patients presents full recovery of the cardiac function; however, in children with significant ventricular dysfunction secondary to ischemic diseases, a better evolution is observed [1][2][3] .…”

“…Among adults with myocardial infarction (MI) submitted to coronary artery reperfusion, only a small number of patients presents full recovery of the cardiac function; however, in children with significant ventricular dysfunction secondary to ischemic diseases, a better evolution is observed [1][2][3] . The proliferation of new cardiomyocytes can be one of the compensation mechanisms that needs to be better understood.…”