Respiratory distress is a very frequent symptom in infants with acyanotic congenital heart disease. Some of the specific physiological and pathological mechanisms involved in this association have been presented in Pediatrics.1 That communication stressed the frequency with which cardiac failure associated with large left-to-right shunts presents with respiratory distress, often misinterpreted as being due to pulmonary disease.

It has, however, also been long recognized that there is a high incidence of pulmonary infection in infants with large left-to-right shunt lesions. The cause of these frequent infections in such patients is not yet evident, but a possible explanation now seems to be suggested from recent observations at autopsy.

This content is only available via PDF.
You do not currently have access to this content.