A HIGH PROPORTION of infants with congenital heart disease, cardiac enlargement, and left-to-right shunt with pulmonary hypertension, develop major degrees of pulmonary atelectasis and emphysema.1,2 I recently studied two such infants with radiographic abnormalities in the left hemithorax, due to atelectasis of the left-lower lobe and emphysema of the left-upper lobe. There was no clinical evidence of these pulmonary abnormalities and the roentgen appearance of the atelectatic left-lower lobe suggested a paraspinal mass. Both infants subsequently died, partially as the result of these pulmonary complications. Autopsy confirmed the radiographic findings and helped to elucidate their production.
These two cases are therefore reported to draw attention to this roentgen pattern, so that its recognition will indicate the urgent need for therapy to reduce pulmonary blood flow and hypertension.
Case 1.—This 4-month-old was admitted to the hospital because of failure to thrive. Physical examination showed a mongoloid female with
BRYK D. Atelectasis, Emphysema, and Heart Diseases: A Pattern of Left Lung Disease in Infants Associated With Left-to-Right Shunt. Am J Dis Child. 1965;110(1):100–104. doi:10.1001/archpedi.1965.02090030106018
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