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Persistent transitional circulation. Roentgenographic findings in thirteen infants
Insights
Persistent transitional circulation (PTC) syndrome in newborns commonly causes congestive heart failure and cyanosis. Imaging reveals heart strain and shunting, with abnormalities resolving in survivors within days.
Area of Science:
- Pediatric Cardiology
- Neonatal Medicine
- Diagnostic Imaging
Background:
- Persistent transitional circulation (PTC) syndrome is a significant cause of neonatal congestive heart failure and cyanosis.
- The incidence of congestive heart failure in reported PTC syndrome cases is notably high.
Purpose of the Study:
- To review imaging findings in infants diagnosed with persistent transitional circulation (PTC) syndrome.
- To characterize the typical presentation and resolution of cardiopulmonary abnormalities in PTC syndrome.
Main Methods:
- Retrospective review of chest roentgenograms from 13 infants.
- Retrospective review of angiocardiograms from 11 infants.
- Analysis of imaging findings related to congestive heart failure, shunting, and myocardial function.
Main Results:
- Chest radiographs commonly showed signs of congestive heart failure, including pulmonary venous congestion, cardiomegaly, hepatomegaly, and pleural effusions.
- Angiocardiography revealed right-to-left shunting via the ductus arteriosus, ventricular dilatation, impaired myocardial function, and reduced ventricular emptying.
- Cardiopulmonary abnormalities resolved in survivors within 2-6 days.
Conclusions:
- Persistent transitional circulation (PTC) syndrome is a frequent and critical condition in newborns, presenting with significant congestive heart failure and cyanosis.
- Diagnostic imaging plays a crucial role in identifying the characteristic hemodynamic and structural abnormalities of PTC syndrome.
- Prompt recognition and management are essential, as cardiopulmonary function can improve rapidly in surviving infants.
Abstract:
Chest roentgenograms in 13 infants and angiocardiograms in 11 infants with persistent transitional circulation (PCT) syndrome were reviewed. Chest radiographs typically revealed congestive heart failure with pulmonary venous congestion, cardiomegaly, hepatomegaly, and pleural effusions. Angiocardiography demonstrated a right-to-left shunt through the ductus arteriosus, ventricular dilatation, poor myocardial function, and ventricular emptying. Cardiopulmonary abnormalities resolved over a period of 2-6 days in survivors. PTC syndrome as seen at the authors' institution has been an important and relatively common cause of congestive heart failure and cyanosis in the newborn. The incidence of congestive failure was higher than in other reported series.