Extravascular Lung Water in Infants and Children with Congenital Heart Disease
The pathophysiology of congestive heart failure (CHF) in infants and children with left-to-right shunts is unknown. The clinical findings of cardiomegaly, hepatomegaly, tachycardia, tachypnea, and failure to thrive—although well known to the pediatric cardiologist as indicative of CHF—present a mystery to the physiologist who tries to correlate these findings with hemodynamic parameters. Infants with a large ventricular septal defect (VSD) and CHF more often than not have normal ventricular function on echocardiograms and angiocardiograms, as well as reasonably low left atrial pressures. What then is the mechanism of CHF in these patients?
KeywordsPermeability Cardiol Doyle