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May 1955

Congestive Failure in the Newborn Caused by Cerebral A-V Fistula: A Clinical and Pathological Report of Two Cases

Author Affiliations

Trainee, National Heart Institute (Dr. Silverman).; From the Departments of Pediatrics and Pathology, Harvard Medical School, and the Sharon Cardio-Vascular Unit of the Children's Medical Center.

AMA Am J Dis Child. 1955;89(5):539-543. doi:10.1001/archpedi.1955.02050110653003

Congestive failure with gross cardiomegaly is a relatively rare condition in the early neonatal period. From the etiological viewpoint, four main groups have to be considered. First, there are the developmental anomalies of the heart, chiefly aortic atresia, transposition of the great vessels, and true truncus arteriosus.1 Secondly, there is the primary myocardial disease group,2 which includes five pathological entities often indistinguishable clinically from each other. Thirdly, prolonged episodes of paroxysmal auricular tachycardia3 may result in a very large heart. Lastly, extracardiac causes of increased cardiac output may also produce marked cardiac enlargement. The last group consists principally of two entities—a large patent ductus arteriosus4 and severe hemolytic anemia, particularly erythroblastosis fetalis.5 Potter6 has added a third condition to this group, namely, multiple telangiectasias of the cerebral vessels. Still another, hitherto undescribed, extracardiac cause of marked cardiomegaly with congestive failure in a newborn infant

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