Diagnostic Criteria for Transient Myocardial Ischemia in Newborn Infants with Intrauterine Growth Retardation
Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
*Corresponding author: Umida F. Nasirova, PhD, Assistant Professor, Department of Neonatology, Tashkent Pediatric Medical Institute, 223, Bogishamol str., 100140, Tashkent, Uzbekistan. Tel/Fax: 998-71-2265554, 998-97-7130201, E-Mail:firstname.lastname@example.org
Metabolic and hemodynamic disturbances in newborns with intrauterine growth retardation resulting from the transferred intrauterine hypoxia, lead to the development of transient myocardial ischemia. Study included 158 newborn infants with intrauterine growth retardation, 83% of which have the asymmetric and 17% - the symmetric form of IUGR, revealed differences in heart rate due to higher dispersion parameters of cardiac rhythm. It was determined that in infants with intrauterine growth retardation heart rate, respiratory rate accelerated and blood pressure increased in compare with the newborns in the control group. According to the ECG examination results, were revealed the signs of focal changes of ST-T, accompanied by inversion of the ST-T segment below the isoline, which accompanied with the positive and peaked T waves, considered as myocardial ischemia. In infants with intrauterine growth retardation, survived after perinatal damage of the central nervous system, the prolongation of the QRST interval was noted in compare with the control group newborns, which could be an indicator of conjunction of hypoxic and ischemic changes in the myocardium. Clinical manifestations of transient myocardial ischemia followed by pale skin, acrocyanosis, and perioral cyanosis against dullness of heart sounds. Obtained results deepened an understanding of posthypoxic myocardial dysfunction, which is characterized by cardiac rhythm and conductivity disturbances, as well as changes in ventricular complex, and causing the need for electrocardiographic screening in the neonatal period.
1. Adams JM. Neonatology. In: Carson A, Bricker JT, McNamara DG. The science and practice of pediatric cardiology. Philadelphia-London: Lea & Febiger 1993.
2. Bartelds B, Knoester H, Beaufort Krol GC, et al. Myocardial lactate metabolism in fetal and newborn lambs. Circulation 1999; 99(14):1892-1897.
3. Farru O, Rizzardini M, Gurman N. Transient myocardial ischemia of the newborn infant. Rev Chil Pediat 1987; 58:121-126.
4. Oskolkov MK, Kupriyanov OO. Electrocardiography in children. Moscow, 1986. [in Russian].
5. Prakhov AV Systematization of neonatal functional cardiopathies. Ros Vestn Perinatol Pediat 2010; 2:14-18. [in Russian].
6. Primhak R, Jedeikin R, Ellis G, et al. Myocardial ischemia in asphyxia neonatorum. Acta Paediatr Scand 1985; 74:595-600.
7. Simonova LV, Kotlukova NP, Galdukova NV, Karpova OY, Yerofeyeva MY. Posthypoxic maladjustment of the cardiovascular system in newborn babies. Ros Vestn Perinatol Pediat 2001; 2:8-12. [in Russian].
8. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953 Jul-Aug; 32(4):260-7.
9. Ballard JL, Khoury JC, Wedig K, et al. New Ballard Score, expanded to include extremely premature infant. J Pediatrics 1991; 119:417-423.
The fully formatted PDF version is available.
Int J Biomed. 2012;2(2):113-116.©2012 International Medical Research and Development Corporation. All rights reserved.