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Papillary muscle necrosis in neonates and infants--analysis of 209 autopsies
1Department of Pathology, Seoul National University College of Medicine, Korea.
Abstract:
A total of 209 consecutive neonate and infant autopsies were reviewed with special attention to papillary muscle necrosis (PMN) of the heart. Associated major pathological findings were analysed for the evaluation of significant pathological accompaniments of PMN. PMN was found in 52 cases among 171(30.4%) neonates and major pathological accompaniments were bronchopneumonia, hyaline membrane disease, hypoxic neuronal change, sepsis, subarachnoid hemorrhage, disseminated intravascular coagulation (DIC) and acute tubular necrosis, among which hypoxic neuronal change and ATN had a statistically significant higher incidence when compared with the control group. (p < 0.005). PMN was found in 13 cases among 38(34.2%) infants and accompaniments were congenital heart disease, sepsis, bronchopneumonia, DIC and hypoxic neuronal change, all of which showed no difference from the control group in incidence. The results imply that PMN is a kind of organ damage in stressed subjects regardless of age, that it is not a special form of myocardial injury in any specific age group including the newborn period, and is possibly of different pathogenesis and significance.
Insights
Papillary muscle necrosis (PMN) in neonates and infants is linked to organ damage in stressed individuals. This study found PMN is not specific to any age group and may have varied causes.
Area of Science:
- Pathology
- Cardiovascular Pathology
- Neonatal and Infant Autopsy Studies
Background:
- Papillary muscle necrosis (PMN) is a cardiac finding.
- Understanding PMN's prevalence and associated pathologies in neonates and infants is crucial.
Purpose of the Study:
- To investigate the incidence of PMN in neonates and infants.
- To identify significant pathological accompaniments of PMN in these age groups.
- To evaluate if PMN is age-specific or indicative of broader organ damage.
Main Methods:
- Retrospective review of 209 consecutive neonate and infant autopsies.
- Detailed analysis of major pathological findings associated with PMN.
- Statistical comparison with a control group to assess incidence differences.
Main Results:
- PMN was identified in 30.4% of neonates (52/171) and 34.2% of infants (13/38).
- In neonates, significant accompaniments included hypoxic neuronal change and acute tubular necrosis (ATN) (p < 0.005).
- In infants, PMN accompaniments showed no significant difference from the control group.
Conclusions:
- PMN represents organ damage in stressed subjects across different age groups.
- PMN is not a myocardial injury specific to newborns or any particular age.
- The pathogenesis and significance of PMN may vary and warrant further investigation.