Congestive Failure in the Newborn Caused by Cerebral A-V Fistula<subtitle>A Clinical and Pathological Report of Two Cases</subtitle>

Abstract

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.¹Secondly, there is the primary myocardial disease group,²which includes five pathological entities often indistinguishable clinically from each other. Thirdly, prolonged episodes of paroxysmal auricular tachycardia³may 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 arteriosus⁴and severe hemolytic anemia, particularly erythroblastosis fetalis.⁵Potter⁶has 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