Correlation of cardiac troponin T level, clinical parameters and myocardial ischaemia in perinatal asphyxia

Introduction: Resource limitation in developing countries may preclude access to cardiac troponin-T assay thereby necessitating reliance on clinical judgment for identification of hypoxic myocardial cellular injury. Objectives: To relate selected clinical signs with elevated serum cardiac troponin-T in asphyxiated term neonates. Methods: Asphyxia was identified by low umbilical arterial blood pH ≤ 7.20 and low five minute Apgar score ≤ 6 while controls were term, non–asphyxiated neonates. All babies were examined for heart rate, heart rhythm irregularities, peripheral pulse volume, respiratory rate, pallor, cyanosis, heart murmur and sensorium. Results: Thirty term, asphyxiated neonates and their matched controls were studied. Central cyanosis, reduced pulse volume, pallor, depressed sensorium; tachycardia and tachypnea were all associated with increased odds ratios for abnormal cardiac troponin–T levels. Conclusion: Clinicians working in resource–limited health facilities should have a high index of suspicion for myocardial cellular injury when these signs are elicited.