IT HAS been well established that the commonest cause of congestive heart failure in the neonatal period is congenital heart disease. Nevertheless other causes exist, and may in fact require a different approach to both diagnosis and therapy.
Hemodynamically any arteriovenous malformation can lead to congestive failure if there is a sufficiently large ateriovenous shunt through a fistulous channel or channels. When the malformation is intracranial the predominant signs and symptoms have, however, usually been neurological,1,2 thereby drawing attention to the site of the lesion.
Prior to 1955 there is little mention in the literature of the association between intracranial arteriovenous fistulas and congestive heart failure in the newborn infant. In the ten-year period 1955 to 1965 there have been 14 cases reported of cerebral arteriovenous aneurysms presenting as congestive heart failure either as the sole or major manifestation of the lesion in the first week of life (Table).
Stern L, Ramos AD, Wiglesworth FW. Congestive Heart Failure Secondary to Cerebral Arteriovenous Aneurysm in the Newborn Infant. Am J Dis Child. 1968;115(5):581-587. doi:10.1001/archpedi.1968.02100010583008