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Patent arterial duct, bottle-meal, and fatal myocardial ischaemia*

Published online by Cambridge University Press:  01 March 2010

Simon Fluri*
Affiliation:
Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital, Bern, Switzerland
Mladen Pavlovic
Affiliation:
Pediatric Cardiology, Inselspital, Bern, Switzerland
Bendicht P. Wagner
Affiliation:
Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital, Bern, Switzerland
*
Correspondence to: Dr Simon Fluri, MD, Department of Pediatrics, Pediatric Intensive Care Unit, Inselspital, CH-3010 Bern. Tel: +41 316 322 111; Fax: +41 316 320 784; E-mail: [email protected]

Abstract

A patent arterial duct in pre-term neonates is frequent. Systemic complications consecutive to left-to-right shunting are well known but fatal myocardial ischaemia has not been described till now. The presented premature baby died from catecholamine refractory cardiogenic shock. Autoptic examination revealed acute ischaemic changes predominantly in the inner third of myocardium, speaking of coronary hypoperfusion due to a steal phenomenon secondary to the patent arterial duct.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2010

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Footnotes

*

This case report obtained the approval for publication from the Institutional Review Board.

References

1.Van Overmeire, B, Smets, K, Lecoutere, D, et al. A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 2000; 343: 674681.CrossRefGoogle ScholarPubMed
2.Couture, A, Veyrac, C, Baud, C, Saguintaah, M, Ferran, JL. Advanced cranial ultrasound: transfontanellar Doppler imaging in neonates. Eur Radiol 2001; 12: 23992410.CrossRefGoogle Scholar
3.Kilbride, H, Way, GL, Merenstein, GB, Winfield, JM. Myocardial infarction in the neonate with normal heart and coronary arteries. Am J Dis Child 1980; 134: 759762.Google ScholarPubMed
4.Rowe, RD, Hoffmann, T. Transient myocardial ischemia of the newborn infant: a form of severe cardiorespiratory distress in full-term infants. J Pediatr 1972; 81: 243.CrossRefGoogle ScholarPubMed
5.Harada, K, Toyono, M, Tamura, M. Effects of coil closure of patent ductus arteriosus on left anterior descending coronary artery blood flow using transthoracic Doppler echocardiography. J Am Soc Echocardiogr 2004; 17: 659663.Google Scholar
6.Way, GL, Pierce, JR, Wolfe, RR, McGrath, R, Wiggins, J, Merenstein, GB. ST depression suggesting ischemia in neonates with respiratory distress syndrome and patent ductus arteriosus. J Pediatr 1979; 95: 609610.Google Scholar
7.Weir, FJ, Ohlsson, A, Myhr, TL, Fong, K, Ryan, ML. A patent ductus arteriosus is associated with reduced middle cerebral artery blood flow velocity. Eur J Pediatr 1999; 158: 484487.Google Scholar
8.Polin, , Fox, . Fetal and Neonatal Physiology, 2nd edition. WB Saunders Company, Philadelphia, USA, 1998.Google Scholar
9.Blaymore Bier, JA, Ferguson, AE, Morales, Y, Liebling, JA, Oh, W, Vohr, BR. Breastfeeding infants who were extremely low birth weight. Pediatrics 1997; 100: E3.CrossRefGoogle ScholarPubMed