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.