Early Neonatal Death Possibly From a Rare Congenital Coronary Artery Anomaly

We report a term female newborn who presented with bradycardia and weak respiratory efforts immediately after birth. Mother had an uneventful pregnancy and the infant was delivered by cesarean section secondary to arrest of labor. The infant did not respond to the neonatal resuscitation and was declared dead 32 minutes after birth. Autopsy findings include left coronary artery (LCA) ostium stenosis and moderate-to-severe chorioamnionitis on placental examination. An autopsy did not find any anatomic or histologic abnormalities in other organ systems that could be attributed to the cause of early neonatal death. To the best of our knowledge, ours is the third case reported in the literature on LCA ostium stenosis presenting immediately after delivery. Unfortunately, all the infants had a fatal outcome. Our case report emphasizes the importance of a meticulous autopsy examination, considering coronary artery anomalies, in case of early neonatal deaths.