Abstract

RHEUMATISM heart disease and congenital heart disease account for the vas majority of cardiac disorders in infancy and childhood. 1 Within the past few years, a number of patients have been seen at the Children's Medical Center with severe heart disease of a type which could not be fitted into either of the two groups mentioned above. They all had the following features in common: (1) cardiomegaly; (2) absence of significant murmurs; (3) electrocardiographic abnormalities, and (4) normal blood pressure. These children did not appear to have rheumatic heart disease because of their very early age and the absence of the major and minor manifestations of rheumatic fever. 2 Congenital heart disease in the conventional sense (i. e., anomalies of the great vessels, valves, and septa) was excluded by the absence of murmurs, abnormal blood pressure, or evidence of shunts in either direction. Paroxysmal auricular tachycardia was excluded by the

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