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Published on: November 4, 2015

Subendocardial infarction associated with ventricular hypertrophy in preterm infants with chronic lung disease

G R Booth1, K Thornton, S Jureidini

  • 1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St Louis, MO 63104, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|August 1, 2008
PubMed

Insights

Preterm infants with bronchopulmonary dysplasia and pulmonary hypertension may develop cardiac complications. Ventricular hypertrophy in these neonates increased their risk for subendocardial infarction, requiring careful monitoring.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Pulmonology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease common in preterm infants.
  • Pulmonary hypertension (PH) frequently complicates BPD, increasing cardiac workload.
  • Ventricular hypertrophy (VH) can develop as a response to sustained pressure overload.

Observation:

  • Three preterm neonates diagnosed with BPD and PH presented with ventricular hypertrophy.
  • These neonates experienced subendocardial infarctions, confirmed by ECG, lab results, or autopsy.
  • The infarctions occurred despite the absence of typical risk factors for coronary artery disease.

Findings:

  • Cardiac hypertrophy, specifically ventricular hypertrophy, was identified as a potential risk factor for subendocardial ischemia and infarction in this cohort.
  • The combination of BPD, PH, and VH creates a unique pathophysiological state predisposing neonates to cardiac events.
  • Subendocardial infarction represents a significant, potentially under-recognized complication in neonates with severe BPD and PH.

Implications:

  • Clinicians should maintain a high index of suspicion for cardiac complications, including infarction, in preterm neonates with BPD and PH.
  • Echocardiographic assessment for ventricular hypertrophy may be warranted in at-risk neonates.
  • Further research is needed to elucidate the precise mechanisms and optimal management strategies for subendocardial infarction in this population.

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