Patent arterial duct, bottle-meal, and fatal myocardial ischaemia.
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.
Fluri
Simon
S
Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital, Bern, Switzerland. simon.fluri@insel.ch
Pavlovic
Mladen
M
Wagner
Bendicht P
BP
D001034:Apgar Score; D001344:Autopsy; D001903:Bottle Feeding / Q000009:adverse effects*; D018450:Disease Progression; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D017809:Fatal Outcome; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011175:Positive-Pressure Respiration / Q000379:methods; D035583:Rare Diseases; D018570:Risk Assessment; D014427:Twins