Abstract
52 newborns uith Transient Myocardial Ischemia (TMI) were admitted to our Departnent between august 1979 and august 1986, (1,5% of all admissions). Gestational age ranged front 29 to 41 (mean 38,9 ± 3<22) weeks, birth weight from 1050 to 4400 (nean 2920 ± 858) 9; there was a history of complicated pregnancy in 23 (57,5% patients and of birth asphyxia in 23 (57,5%). Symplons started within the first 48 of life in 35/52 varying from severe cardiogenic shock to heart murmur usually due to nitral or tricuspid insufficiency, and/or electrocardiographs Q or ST/T abnormalities. Metabolic acidosis in 14/32, hypoxia in 16/52, were observed. 3 patients died: only 1 because of myocardial ischenia. 14 newborns required assisted ventilation, 6 oxygen therapy, 15 digitalis and or diuretics, 8 atropin and 9 isoproterenol. Symptoms subsided within 2 to 43 (mean 14) days in 39 subjects. The EC6 picture reverted to normal in 6-108 (mean 45) days in 38 cases. 25 newborns uere followed up for 2-19 (mean 7, 4) months. In 20 the clinical signs and the ECG became normal; in one the ECG was normal after 5 months but showed again signs of myocardial necrosis 4 months later, one patients with normalized ECG had a syncopal episode and bradycardia at 4 months; 3 patients had normal ECG with murmurs (1 IVD, 2 PDA). 1 patient with myelmeningocele died at 12 months of age because of pulmonary infection. In our experience TMI is associated with birth asphyxia in only 44, 3% of cases, and with hypoxia in 50% of cases. It is probably underexstimated. In the majority of cases the prognosis is favourable. A long long-term follow-up in order to detect possible sequelae related to the neonatal myocardial damage is mandatory.
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Saia, O., Benini, F., Pellegrino, P. et al. DIAGNOSIS, TREATMENT AND FOLLOW-UP OF TRANSIENT MYOCARDIAL ISCHEMIA OF THE NEWBORN. Pediatr Res 22, 226 (1987). https://doi.org/10.1203/00006450-198708000-00080
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DOI: https://doi.org/10.1203/00006450-198708000-00080