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Early survival following in utero myocardial infarction

Published online by Cambridge University Press:  23 July 2018

Peter Cosgrove ,
Shan Modi ,
Karla Lawson ,
Camille Hancock-Friesen  and
Gregory Johnson
Peter Cosgrove*
Affiliation:
Department of Emergency Medicine, Boston Children’s Hospital, Boston, MA, USA
Shan Modi
Affiliation:
Department of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
Karla Lawson
Affiliation:
Department of Trauma and Injury Research Center, University of Texas at Austin, Dell Children’s Medical Center, Austin, TX, USA
Camille Hancock-Friesen
Affiliation:
Department of Pediatric Cardiovascular Surgery Division, Dell Children’s Regional Heart Center, University of Texas at Austin, Dell Children’s Medical Center, Austin, TX, USA
Gregory Johnson
Affiliation:
Department of Pediatric Cardiology, University of Texas at Austin, Dell Children’s Medical Center, Austin, TX, USA
*
Author for correspondence: P. Cosgrove, Department of Pediatric Emergency Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Tel: 512 221 8598; Fax: 617 730 0335; E-mail: Peter.Cosgrove@childrens.harvard.edu
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Abstract

Intrauterine myocardial infarction is a rare and frequently fatal diagnosis. It has been presented in the literature only as case reports and short series. We present a case report of a coronary occlusive intrauterine myocardial infarction and survival and present a systematic review of the literature. This is the first summative description of current data on intrauterine and perinatal myocardial infarction. We performed the systematic review based on the guidelines established by the PRISMA statement. Our population of intrauterine and perinatal myocardial infarction included published cases who presented as a live birth within the first 28 postnatal days, and had a diagnosis of myocardial infarction. We conducted descriptive statistics and regression analysis on short-term mortality as the primary outcome. After applying exclusion criteria we described 84 individual cases of myocardial infarction from 63 full-text articles including our own case. Presentation within the first 12 hours was associated with mortality (OR 3.90, p=0.004). Treatment modalities were varied and inconsistently recorded. The aetiologies and comorbidities are varied in our systematic review. We would have a low threshold to perform viral testing, consider anticoagulation early and coronary imaging if feasible. The use of extracorporeal membranous oxygenation may serve as a bridge to cardiac recovery.

Keywords

Myocardial infarctionperinatalintrauterinegeneral cardiology
Type
Review Article
Information
Cardiology in the Young , Volume 28 , Issue 10 , October 2018 , pp. 1079 - 1087
Copyright
© Cambridge University Press 2018 

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