Negative delayed-enhancement magnetic resonance imaging of the heart suggests a diagnosis of neonatal transient myocardial ischaemia.
We report a term neonate presenting after birth with shock and cyanosis for which he was intubated. Echocardiography showed no contractions of the left ventricle. Systemic circulation was provided by the right ventricle via shunting through the arterial duct. Left ventricular dysfunction was confirmed by electrocardiography and increased troponin T levels. Hemodynamics quickly improved, and the child could be weaned of the ventilator without residual problems. We concluded that the patient suffered from transient myocardial ischaemia. At 3 weeks of life, we performed delayed-enhancement magnetic resonance imaging (DE-MRI) of the heart which did not show signs of permanent macroscopic damage of the myocardium.


CONCLUSIONS
This is the first reported case report on the use of DE-MRI in a neonate with transient myocardial ischaemia. DE-MRI may provide information that helps to predict recovery in the acute stage of left ventricular dysfunction or at a later stage when absence of recovery of left ventricular function needs to be explained.
Brouwers
Arno G A
AG
Department of Paediatric Intensive Care, Academic Hospital Maastricht, Maastricht, The Netherlands. A.Brouwers@mumc.nl
Van Elburg
Ruurd M
RM
Beek
Aernout M
AM
Rammeloo
Lukas A J
LA
D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011379:Prognosis; D020107:Troponin T / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D015415:Biomarkers; D020107:Troponin T