Detection of transitory myocardial ischemia secondary to perinatal asphyxia

Background Transitory myocardial ischemia (TMI) is seen as a complication o f severe asphyxia. Its presentation is variable, ranging from tachypnea to cardiogenic shock, and it is often masked by the predominant disease. The o bjective of this study was to detect TMI secondary to perinatal asphyxia in a population of asphyxiated newborns (NB) in comparison with asphyxiated N E with no evidence of TMI. Methods. From April 1996 to December 1997, 43 asphyxiated (stressed) NE wer e studied. Three were excluded. Patients were placed into two groups: Group A with TMI (n = 33) and Group B without TMI (n = 7). Results, No significant differences were found in gestational age, birth we ight, extrauterine age, Apgar score, or total creatine phosphokinase values between the two groups. Differences were found in CPK-MB levels and in isc hemic electrocardiographic changes and blockages, especially for Group A. I n this group, only 24 (72.7%) were cardiovascularly symptomatic. Conclusions. We conclude that TMI secondary to perinatal asphyxia is more f requent than has been reported. Thus, it would be useful in all asphyxiated NE to measure CPK-MB isoenzyme activity and patients can then be submitted to an electrocardiogram for detection in order to offer opportune treatmen t when required.