to evaluate the utility of echocardiographic exam (echo) for diagnosis and follow up of perinatal posthypoxic myocardial injury.

Patients: 78 newborns aged 0 to 14 days, normal birth weight, with perinatal hypoxia, receveing resuscitation (Apgar score 3-7), but without major congenital heart defects. In all cases were performed: clinical exam, ECG, chest X-ray (Rx.CT), Doppler echocardiography exam (Echo). Most of our patients were evaluated clinically and echo and after 6 months.

The patients had mainly signs of neurological post hypoxic suffering, without signs of severe cardiac involvement. The cardiac exam revealed: systolic murmur (64) and signs of persistent pulmonary hypertension of newborn (PPHN). Chest X-ray: cardiomegaly (35 cases). ECG: severe left ventricle (LV) repolarization disturbances and low voltage of QRS complexes (37), without ischemic changes. Echo performed at 2-7 days of life revealed: the absence of other severe congenital cardiac anomaly; permeability of foramen ovalae (100% cases); myocardial hypertrophy (42 cases) mainly interventricular septal (29), signs of PPHN (6) with mild to severe tricuspid insufficiency and right atrium dilation (28 cases); prolonged isovolumic relaxation period(35), increased myocardial performance index (44), the systolic function normal (all cases) and severe LV diastolic dysfunction (E/A<1) in 45 cases. All the cases received spironolactone 1-2mg/kg/day. Reevaluation at 6 months showed the reduction of the myocardial hypertrophy and of the tricuspid regurgitation, with a normal LV diastolic function.

The perinatal hypoxia can induce the apparition of a true posthypoxic cardiomypathy at more than 69% of patients, the signs of cardiovascular suffering missing often. Echo exam and especially Tei Index is the main method for diagnosis and follow up of perinatal hypoxic cardiomyopathy and is necessary from the first week of life.