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Albert A. Clairmont, MD; Neil J. Hart, MD; Donald T. Rooker, MD; Robert H. Franch, MD

JAMA. 1975;233(7):813-814.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

MOST children with severely enlarged tonsils and adenoids do not develop cor pulmonale. The children who do seem to have an abnormal reactivity of the pulmonary vasculature to the hypoxia, hypercapnia, and acidosis secondary to chronic alveolar hypoventilation. The cardiorespiratory syndrome was first described in 1965, with additional reported cases bringing the total to about 35 in the literature.^1,2 However, very few of these patients have had concomitant congenital heart disease.³ The early recognition and early correction of extracardiac factors aggravating pulmonary artery hypertension is particularly important in the child with operable congenital heart disease.

Report of a Case

A 6-year-old girl with Down syndrome had cardiac catheterization at age 2 years, establishing the diagnosis of a large ventricular septal defect (Table). Over the past three years, her sleep pattern had become fitful, with difficult, stertorous breathing. She perspired profusely and snored loudly while asleep. She would often . . . [Full Text PDF of this Article]

Author Affiliations
From the departments of surgery, Division of Otolaryngology (Drs. Clairmont and Rooker) and medicine, Division of Cardiology (Drs. Hart and Franch), Emory University School of Medicine, Atlanta.

Footnotes
Reprint requests to 401 Woodruff Memorial Bldg, Emory University Campus, Atlanta, GA 30322 (Dr. Franch).

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