Abstract
The clinical course of 19 infants with severe respiratory symptoms associated with the presence of both congenital heart disease and gastroesophageal reflux is described. Down Syndrome or central nervous system disease was present in 12 of the 19 infants. The identification of reflux as a major or additional cause of the respiratory complications was often overlooked. Medical therapy alone was successful in only one of the 19 patients. Early repair or palliation of the cardiac malformation with or without subsequent antireflux surgical procedure was associated with relief of the symptoms in 13 patients.
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