Assessment of Myocardial Function in Birth Asphyxia

Abstract

Introduction: Perinatal asphyxia has effect on various body system and cardiovascular system is one of them. We have assessed Myocardial function in Birth asphyxia by clinical evaluation, electrocardiography & echocardiogram.

Design: Cross sectional observational study. Setting - Hospital based.

Method: 20 severely asphyxiated & 20 moderately asphyxiated newborns were compared with 20 normal newborns. Serial Electrocardiograms were taken on 1st 3rd & 7th day of life. Left ventricular Ejection Fraction, diameters & % shortening were calculated by echocardiogram.

Results: Respiratory distress was present in 70% of severely asphyxiated & 25% of moderately asphyxiated newborns. Shock was present in 75% of severely asphyxiated newborns and 15% of moderately asphyxiated newborns. 20% & 15 % newborns with severe asphyxia had pansystolic murmur & congestive cardiac failure respectively. Abnormal ST segment was present in 40% & 35 % newborns with severe & moderate asphyxia respectively within 24 hours. T wave changes were seen in 70%, 50% & 10% newborns with severe, moderate asphyxia & control respectively in the first reading. LVED diameter, LVES diameter was higher in asphyxiated newborns. % shortening of left ventricle & ejection fraction were reduced in asphyxiated newborns.

Conclusion: ECG is a very sensitive indicator for establishing the diagnosis of myocardial ischaemia. Echocardiographic evaluation substantiates the findings of myocardial dysfunction in birth asphyxia.