PEDIATRICS Vol. 17 No. 1 January 1956, pp. 45-57
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COARCTATION OF THE AORTA WITH CONGESTIVE HEART FAILURE IN INFANCY—MEDICAL TREATMENT

Henry T. Lang Jr. M.D.1 and Alexander S. Nadas M.D.1

1 Sharon Cardiovascular Unit of the Children's Medical Center and Department of Pediatrics, Harvard Medical School

Nine infants with uncomplicated coarctation of the aorta in congestive heart failure are presented.

The symptomatology was dominated by feeding problems, failure to thrive, dyspnea, and cyanosis.

On physical examination, in addition to signs referable to the coarctation, signs of both left and right-sided congestive heart failure were noted.

The roentgenographic survey revealed marked generalized cardiomegaly and pulmonary congestion.

Electrocardiograms in the infants less than 6 months of age showed left, right, or combined ventricular hypertrophy, whereas those more than 6 months of age all showed left ventricular hypertrophy.

Medical treatment, consisting of digitalis, oxygen, mercurial diuretics, diet low in sodium, and antibiotics, was successful in all instances. Digitalization was maintained throughout infancy. Operative intervention can be safely postponed until late childhood unless medical management is not successful.

A review of the pertinent literature is presented.

Submitted on May 25, 1955
Accepted on July 6, 1955