Congenital coronary arteriopathy and myocardial infarctions occur with tricuspid atresia.

Sinusoids and coronary arterial fistulae are well described in fetuses and infants with single ventricles. Coronary arteriopathy is well described as a cause of myocardial infarction in adults and in children with familial hypercholesterolemias. To the best of our knowledge, pathologic alterations in coronary arteries (coronary arteriopathy) have only twice before been described as the cause of infarction in neonates. We present the case of a newborn with perinatal myocardial infarctions and death in the setting of extensive coronary arteriopathy and tricuspid atresia. The child had a pulseless arrest immediately after birth. Autopsy showed multiple areas of infarction ranging in age from acute to >10 days old.