Surgical Management of Extensive Perinatal Myocardial Infarction

Myocardial infarction in a neonate with severe hypertrophic cardiomyopathy: a case report

Hypertrophic cardiomyopathy (HCM) is a rare and heterogeneous disorder in newborns, which can predispose them to other cardiac conditions such as myocardial infarction (MI). This case report describes the clinical presentation of a premature infant born at 30 weeks of gestation, who developed cardiac failure due to myocardial ischemia. The newborn exhibited distal acrocyanosis and respiratory distress shortly after birth. Echocardiography revealed significant left ventricular hypercontractility and hypertrophy, along with moderate pericardial effusion, tricuspid regurgitation and mitral regurgitation. Despite treatment with furosemide and inotropes, the patient's condition deteriorated, leading to demise after 14 days. Early detection of MI in newborns with vascular complications and HCM plays a crucial role in their management. In conclusion, the coexistence of acute MI and hypertrophic cardiomyopathy may be indicative of a fatal outcome. Hypertrophic cardiomyopathy (HCM) is a rare and heterogeneous disorder in newborns, which can predispose them to other cardiac conditions such as MI. This case report describes the clinical presentation of a premature infant born at 30 weeks of gestation, who developed cardiac failure due to myocardial ischemia. The newborn exhibited distal acrocyanosis and respiratory distress after birth. Echocardiography revealed significant left ventricular hypercontractility, moderate pericardial effusion, tricuspid regurgitation and mitral regurgitation. Despite treatment, the patient's condition deteriorated, leading to demise after 14 days. Early detection of MI in newborns with vascular complications and HCM plays a crucial role in their management. In conclusion, the coexistence of acute MI and hypertrophic cardiomyopathy may be indicative of a fatal outcome.

Emergency treatment of thrombus in right coronary artery and aortic root in a newborn with acute myocardial infarction

Perinatal myocardial infarction caused by aortic root and coronary artery thrombosis in neonatal period is extremely rare and has a gloomy prognosis that may cause devastating complications. A 3-h newborn baby who had acute myocardial infarction findings on postnatal electrocardiography had a thrombus in the aortic root with hyperechogenic right coronary artery region, and impaired right ventricular functions on echocardiography. The patient was urgently operated and thrombus was successfully removed from the aortic root and the right coronary artery. In conclusion, for large thrombi posing a risk for embolization in the aortic root, an urgent surgical thrombectomy procedure should be performed.

The Case of Myocardial Infarction in a Fifteen-Year-Old Adolescent Caused by Toxic Substances

The article reveals about the clinical accident of myocardial infarction in an adolescent after visiting a night club, where he had been drinking tequila. A "sniper" test was performed at home and showed synthetic marihuana in urine. The uniqueness of this case is the adolescent's difficult premorbid condition (severe diabetes mellitus type 1 and sub-compensated hypothyreosis) and the clinical course of the disease had caused difficulty in diagnosis which led to a belated hospitalization on the third day. Considering pain syndrome, infarction-like findings in ECG (ST elevation), high levels of cardiospecific enzymes (troponin elevated 70 times, aspartate aminotransferase-two times, creatine phosphokinase-4 times, lactate dehydrogenase and alkaline phosphatase-two times) and their slow tendency to normalize-a non-Q myocardial infarction diagnosis was performed. After complex treatment, the general condition of the patient improved; he was discharged from the clinic in satisfactory general condition and was given recommendations for further rehabilitation. Given the potential for premature death and long-term disability with the development of negative individual and social consequences, the correct diagnostic assessment in such cases becomes particularly relevant.

Myocardial Infarction in Neonates: A Diagnostic and Therapeutic Challenge

Neonatal acute myocardial infarction is an uncommon entity. We describe the case of a 4-day-old term baby who presented with respiratory distress and distal acrocyanosis. The chest radiograph demonstrated cardiomegaly without pleural effusion, and examination revealed hepatomegaly. An electrocardiogram revealed QS pattern in leads I, aVL, and V6, suggestive of ischemia. Cardiac enzymes were elevated, and echocardiogram revealed moderate left ventricular dysfunction with a thrombus at the level of the left atrial appendage. The patient required hemodynamic stabilization, vasodilatation to avoid congestive heart failure, and anticoagulation with heparin and aspirin. In the context of this unusual diagnosis, we reviewed our experience over the last 17 years as well as the existing literature on neonatal myocardial infarction.