Perinatal myocardial infarction in a newborn with a structurally normal heart

Area of Science:

• Cardiology
• Neonatal Medicine
• Pathology

Background:

• Myocardial infarction (MI) in newborns is uncommon, particularly without congenital heart disease or coronary anomalies.
• Congenital heart disease and coronary artery anomalies are typical causes of neonatal cardiac events.

Observation:

• A newborn presented with symptoms of congestive heart failure and cardiovascular collapse shortly after birth.
• Initial clinical presentation mimicked severe conditions like hypoplastic left heart syndrome or critical aortic stenosis.

Findings:

• Autopsy revealed a massive myocardial infarction in the infant.
• The infarction was caused by thromboembolic occlusion of the left main coronary artery.
• Evidence suggests the coronary artery event occurred in utero.

Implications:

• This case underscores the possibility of in utero coronary artery thrombosis leading to neonatal myocardial infarction.
• It expands the differential diagnosis for neonatal heart failure and cardiovascular collapse.
• Highlights the importance of considering thromboembolic events in structurally normal neonatal hearts presenting with cardiac compromise.