Myocardial changes in neonates dying of asphyxia neonatorum

Ten neonates, asphyxiated at birth, were studied by Apgar score, ECG ischaemic score grading (ECGisg), Cardiothoracic (CT) ratio, biochemical parameters like CPK, CPK-MB fraction during life; and they were subjected to postmortem study with particular attention to the changes in the heart. The study revealed that 7 out of 10 asphyxiated neonates showed variable evidences of myocardial damage; but the extent of damage though well correlated with biochemical parameters, did not correspond well with the extent of asphyxia and the survival period. In rest 3 cases, myocardial damage was not overt though there was evidence of asphyxia and evidence of myocardial damage in the form of elevated CPK-MB level. These patients probably had died of "Biochemical Lesion" as described by Rudolf Peter.