[Transient myocardial ischemia in newborn infants]

Thirty new born babies with Apgar scores of 5 or less were randomly selected for clinical and electrocardiographic study. Twenty five had electrocardiographic changes of myocardial ischaemia (ST and T wave abnormalities). Generalised low voltage was a common finding (21 cases) whilst pathological Q waves were observed more rarely (5 cases) but did not seem to carry a poor prognosis. Seventeen babies had cardiac clinical signs: isolated tricuspid regurgitation or associated with cardiac failure. Five babies died; autopsy showed subendocardial infarction in all cases. The electrocardiogram of the survivors returned to normal within 15 days in 80% of cases. The authors discuss the physiopathology and demonstrate a clear relationship between neonatal hypoxia and myocardial ischaemia. Attentive clinical examination and systematic electrocardiography in these babies at risk seem to be justified for the detection and treatment of myocardial ischaemia.