• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of archdischArchives of Disease in ChildhoodVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Arch Dis Child. Dec 1979; 54(12): 918–930.
PMCID: PMC1545765

Coronary arterial lesions and myocardial necrosis in stillbirths and infants.

Abstract

In a detailed study of the coronary arterial tree and myocardium in 256 stillbirths and infants, abnormalities of the coronary arterial tree were noticed in 79 infants, and necrotic lesions of the myocardium in 111 infants. Of the 79 infants with arterial lesions, 70 had associated myocardial necrosis or scarring, or both; the group with coronary arterial lesions, therefore, accounted for the majority of cases with myocardial damage. The myocardial lesions varied from small zones of subendocardial damage, to larger 'geographical' zones of necrosis scattered haphazardly through the myocardium, and a small group where massive necrotic lesions of the papillary muscles were present. While the coronary arterial lesions were associated with all three patterns, they were particularly found in association with the 'geographical' and papillary muscle changes. The coronary arterial lesions varied from zones of acute focal, medial necrosis to severe proliferative intimal lesions and medial defects, with a distinct progression of changes from the acute to the more established lesions. The coronary arterial lesions were seen most commonly in association with conditions that could produce severe hypoxia, and it is argued that they result from hypoxia. It is suggested further that the myocardial damage, so commonly associated with the coronary arterial lesions, could compromise the ability of the hypoxic infant to respond to such an insult. The coronary arterial lesions seen in this group of young infants could offer one explanation for the later development of a variety of other pathological conditions seen in adolescents and young adults.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (5.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Allison PR, Bleehan N, Brown W, Pickering GW, Robb-Smith AH, Russell RP. The production and resolution of hypertensive vascular lesions in the rabbit. Clin Sci. 1967 Aug;33(1):39–51. [PubMed]
  • Berry CL. Myocardial ischaemia in infancy and childhood. J Clin Pathol. 1967 Jan;20(1):38–41. [PMC free article] [PubMed]
  • Bucciarelli RL, Nelson RM, Egan EA, Eitzman DV, Gessner IH. Transient tricuspid insufficiency of the newborn: a form of myocardial dysfunction in stressed newborns. Pediatrics. 1977 Mar;59(3):330–337. [PubMed]
  • BURNARD ED, JAMES LS. Failure of the heart after undue asphyxia at birth. Pediatrics. 1961 Oct;28:545–565. [PubMed]
  • Cross KW. Resuscitation of the asphyxiated infant. Br Med Bull. 1966 Jan;22(1):73–78. [PubMed]
  • deSA DJ. Myocardial changes in immature infants requiring prolonged ventilation. Arch Dis Child. 1977 Feb;52(2):138–147. [PMC free article] [PubMed]
  • DeSa DJ, Nicholls S. Haemorrhagic necrosis of the adrenal gland in perinatal infants: a clinico-pathological study. J Pathol. 1972 Mar;106(3):133–149. [PubMed]
  • Esterly JR, Oppenheimer EH. Some aspects of cardiac pathology in infancy and childhood. IV. Myocardial and coronary lesions in cardiac malformations. Pediatrics. 1967 Jun;39(6):896–903. [PubMed]
  • Eto T, Onoyama K, Tanaka K, Omae T, Yamamoto T. Early vascular changes in the intestine of bilaterally nephrectomised rats. J Pathol. 1978 Mar;124(3):141–148. [PubMed]
  • Franciosi RA, Blanc WA. Myocardial infarcts in infants and children. I. A necropsy study in congenital heart disease. J Pediatr. 1968 Sep;73(3):309–319. [PubMed]
  • GAULT MH, USHER R. Coronary thrombosis with myocardial infarction in a newborn infant. Clinical, electrocardiographic and post-mortem findings. N Engl J Med. 1960 Aug 25;263:379–382. [PubMed]
  • Goldby FS, Beilin LJ. How an acute rise in arterial pressure damages arterioles. Electron microscopic changes during angiotensin infusion. Cardiovasc Res. 1972 Sep;6(5):569–584. [PubMed]
  • GORE I, SMITH J, CLANCY R. Congenital aneurysms of the coronary arteries with report of a case. Circulation. 1959 Feb;19(2):221–227. [PubMed]
  • GRUENWALD P. Necrosis in the coronary arteries of newborn infants. Am Heart J. 1949 Dec;38(6):889–illust. [PubMed]
  • LEVENE CI. The early lesions of atheroma in the coronary arteries. J Pathol Bacteriol. 1956 Jul;72(1):79–82. [PubMed]
  • LOBER PH. Pathogenesis of coronary sclerosis. AMA Arch Pathol. 1953 May;55(5):357–383. [PubMed]
  • MacMahon HE, Dickinson PC. Occlusive fibroelastosis of coronary arteries in the newborn. Circulation. 1967 Jan;35(1):3–9. [PubMed]
  • MOON HD. Coronary arteries in fetuses, infants, and juveniles. Circulation. 1957 Aug;16(2):263–267. [PubMed]
  • Naeye RL. Pulmonary arterial abnormalities in the sudden-infant-death syndrome. N Engl J Med. 1973 Nov 29;289(22):1167–1170. [PubMed]
  • ROBERTSON JH. Stress zones in foetal arteries. J Clin Pathol. 1960 Mar;13:133–139. [PMC free article] [PubMed]
  • Rowe RD, Hoffman T. Transient myocardial ischemia of the newborn infant: a form of severe cardiorespiratory distress in full-term infants. J Pediatr. 1972 Aug;81(2):243–250. [PubMed]
  • Rowe RD, Izukawa T, Mulholland HC, Bloom KR, Cook DH, Swyer PR. Nonstructural heart disease in the newborn. Observations during one year in a perinatal service. Arch Dis Child. 1978 Sep;53(9):726–730. [PMC free article] [PubMed]
  • Salyer WR, Salyer DC, Hutchins GM. Local arterial wall injury caused by thromboemboli. Am J Pathol. 1974 May;75(2):285–300. [PMC free article] [PubMed]
  • SCHORNAGEL HE. Intimal thickening in the coronary arteries in infants. AMA Arch Pathol. 1956 Dec;62(6):427–432. [PubMed]
  • Sevitt S. Arterial wall lesions after pulmonary embolism, especially ruptures and aneurysms. J Clin Pathol. 1976 Aug;29(8):665–674. [PMC free article] [PubMed]
  • Tyson JE, deSa DJ, Moore S. Thromboatheromatous complications of umbilical arterial catheterization in the newborn period. Clinicopathological study. Arch Dis Child. 1976 Oct;51(10):744–754. [PMC free article] [PubMed]
  • Vlodaver Z, Abramovici A, Neufeld HN, Liban E. Coronary arteries in Yemenites. J Atheroscler Res. 1967 Mar-Apr;7(2):161–170. [PubMed]
  • Whitehead R, Dunnill MS. Primary dissecting aneurysms of coronary arteries. J Pathol. 1969 Sep;99(1):33–37. [PubMed]
  • WILENS SL. The nature of diffuse intimal thickening of arteries. Am J Pathol. 1951 Sep-Oct;27(5):825–839. [PMC free article] [PubMed]
  • Witzleben CL. Idiopathic infantile arterial calcification--a misnomer? Am J Cardiol. 1970 Sep;26(3):305–309. [PubMed]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...