Finley J P, Howman-Giles R B, Gilday D L, Bloom K R, Rowe R D
J Pediatr. 1979 Feb;94(2):263-70. doi: 10.1016/s0022-3476(79)80841-0.
Five term and two premature newborn infants were referred for respiratory distress and congestive heart failure, and were found to have electrocardiographic Q or ST-T abnormalities suggesting ischemia. Echocardiographic and/or hemodynamic assessment excluded anatomic heart disease in six infants. In three infants, moderate or severe hemodynamic impairment within 36 hours of age was suggested by these studies. Myocardial perfusion images in all patients showed very poor myocardial uptake of thallium 201, compatible with global myocardial ischemia. Infants of similar age with myocarditis, or with congenital heart disease and congestive failure, had normal myocardial uptake. Rapid clinical improvement occurred within three to seven days. Two to five months later, all infants were well. Two had persistent electrocardiographic abnormalities but repeat thallium 201 imaging in six demonstrated almost normal myocardial uptake. These data provide further evidence that perinatal respiratory distress may be associated with myocardial dysfunction and congestive heart failure in some infants without anatomic heart disease, and suggest that myocardial dysfunction in these infants is associated with global myocardial ischemia, most of which is transient. The timing and nature of the insult causing the ischemia are unclear.
五名足月儿和两名早产儿因呼吸窘迫和充血性心力衰竭前来就诊，经检查发现心电图有Q波或ST-T异常，提示存在心肌缺血。超声心动图和/或血流动力学评估排除了六名婴儿的解剖学心脏病。这些研究表明，三名婴儿在36小时内出现了中度或重度血流动力学损害。所有患者的心肌灌注图像显示铊201心肌摄取非常差，符合整体心肌缺血。患有心肌炎、先天性心脏病和充血性心力衰竭的同龄婴儿心肌摄取正常。三到七天内临床症状迅速改善。两到五个月后，所有婴儿情况良好。两名婴儿心电图异常持续存在，但六名婴儿再次进行铊201显像显示心肌摄取几乎正常。这些数据进一步证明，围产期呼吸窘迫可能与一些无解剖学心脏病的婴儿的心肌功能障碍和充血性心力衰竭有关，并表明这些婴儿的心肌功能障碍与整体心肌缺血有关，其中大部分是短暂性的。导致缺血的损伤时间和性质尚不清楚。
