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International Journal of Pediatrics
Volume 2010, Article ID 658065, 3 pages
http://dx.doi.org/10.1155/2010/658065
Case Report

Massive Myocardial Infarction in a Full-Term Newborn: A Case Report

1Center of Fetal Cardiology, Policlinico San Donato IRCCS, 20097 Milan, Italy
2Neonatal Intensive Care Unit, P.O. Macedonio Melloni, Italy
3Pathologic Anatomy Section, P.O. Macedonio Melloni, Milan, Italy

Received 15 March 2010; Accepted 7 April 2010

Academic Editor: Frans J. Walther

Copyright © 2010 Vlasta Fesslova et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A full-term female newborn with neonatal asphyxia and severe anemia (Hb 2.5 g/dL) with normal heart developed a massive myocardial infarction. No examinations were performed during pregnancy for parental nomadism. The baby had immediate external cardiac massage, ventilatory assistance, and blood transfusion. Cardiomegaly was evident at chest X-ray and marked signs of ischemia-lesion at ECG. Echocardiography showed dilated, hypertrophic, and hypocontractile left ventricle (LV), mitral and tricuspid regurgitation, and moderate pericardial effusion. Rh isoimmunization and infective agents were excluded at laboratory tests. Despite the treatment with inotropes, hydrocortisone, and furosemide, the baby worsened and died at 45 hours of life. Postmortem examination showed diffuse subendocardial infarction of LV and diffuse parenchymal hemorrhages and myocardial hypertrophy, increase of eosinophilia, and polymorphonucleated cells at histology. Our patient suffered apparently from longstanding fetal anemia of unknown etiology that led to perinatal distress, severe hypoxia, and massive myocardial infarction, unresponsive to the therapy.