Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

• We present a patient with myocardial ischemia secondary to perinatal asphyxia.
• Serum biomarkers may provide predictive value in infants with myocardial ischemia.
• ECMO may be useful in supporting infants with myocardial ischemia.
• Select patients with myocardial dysfunction may be managed with VV ECMO.

Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO) and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.