MMP2 and asphyxia: Severity of cardiac impairment is determined by the degree of perinatal asphyxia.15 The transitory myocardial ischemia may manifest in the mild form as tachypnea or as severe as cardiogenic shock.16 Myocardial insult or ischemic myocardial necrosis in both ventricles occur due to severe asphyxia and poor perfusion.3 Also, reperfusion injury may produce severe cardiovascular disturbances with high morbidity and mortality through degradation of cardiac myosin light chain 1 protein (MLC1) by matrix metalloproteinase-2 (MMP-2).17