Right-to-Left Shunting through a Patent Ductus arteriosus in a Newborn with Myocardial Infarction

An extensive infarction of the left ventricle in a newborn following occlusion of the orifice and proximal portion of the left coronary artery probably resulted from a paradoxical embolus originating from a thrombosis of the ductus venosus after catheterization. Left ventricular dysfunction secondary to the infarction led to right-to-left shunting through the ductus arteriosus which had remained widely patent. The differential diagnosis of cyanosis and circulatory collapse in the neonate is discussed on the basis of the clinical, electrocardiographic and angiocardiographic findings.