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Myocardial necrosis and infarction in newborns and infants

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Abstract

Purpose

This study aimed to investigate the incidence, and underlying associations, of myocardial necrosis occurring in infants undergoing autopsy.

Methods

An autopsy database containing anonymized details of all infant autopsies conducted at Great Ormond Street Hospital between January 1996 and December 2010 was searched to identify all infants with myocardial necrosis. The characteristics of the necrosis and any underlying associations were reviewed.

Results

Myocardial necrosis was recorded in 187 autopsies out of a total of 1,637 (11.4 %), and was localized to the papillary muscles, subendocardial region, or trabeculae in 50.8 % of cases. The most common associations were congenital heart disease, perinatal asphyxia, coronary artery abnormalities, or sepsis. Three cases of apparently idiopathic myocardial infarction were identified and are described in detail.

Conclusions

Myocardial necrosis is relatively common in infants who die and undergo autopsy, and is most commonly associated with congenital heart disease and perinatal asphyxia. Myocardial infarction can occur in infancy in the absence of any apparent underlying cause: the etiology of these cases is unclear.

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Acknowledgments

ARB is supported by a grant from the Lullaby Trust. NJS is part supported by GOSHCC and the NIHR GOSH BRC. This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Authors and Affiliations

  1. Department of Histopathology, Camelia Botnar Laboratories, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK

    Andrew R. Bamber, Jeremy Pryce, Michael Ashworth & Neil J. Sebire

  2. Cardiac Unit, UCL Institute of Cardiovascular Sciences, London, UK

    Andrew Cook

Authors
  1. Andrew R. Bamber
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  2. Jeremy Pryce
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  3. Andrew Cook
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  4. Michael Ashworth
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  5. Neil J. Sebire
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Correspondence to Andrew R. Bamber.

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Bamber, A.R., Pryce, J., Cook, A. et al. Myocardial necrosis and infarction in newborns and infants. Forensic Sci Med Pathol 9, 521–527 (2013). https://doi.org/10.1007/s12024-013-9472-0

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  • DOI: https://doi.org/10.1007/s12024-013-9472-0

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