Symptomatic congenital aortic stenosis in the first year of life

A clinical review of 18 cases of congenital aortic valvular stenosis symptomatic in thefirst year of life was undertaken. The electrocardiogram and thoracic roentgenograms mimic primary endocardial fibroelastosis; auscultatory findings, however, are usually sufficiently localized as to suggest aortic stenosis. Mitral insufficiency was a common finding in left ventriculograms. Pathologic study suggests that infants with aortic stenosis who are symptomatic in the first year of life commonly exhibit infarction of the left ventricular papillary muscles. This, in turn, is a fundamental cause of mitral regurgitation, a factor which may contribute to congestive cardiac failure.