BMJ Case Reports 2012; doi:10.1136/bcr-2012-006289
  • Rare disease

High-output heart failure in a newborn

  1. Rosalina Barroso1
  1. 1Neonatal Intensive Care Unit, Department of Pediatrics-Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal
  2. 2Neuro-Imagiology Department, Hospital Garcia de Orta, Lisbon, Portugal
  1. Correspondence to Dr Maria Inês Mascarenhas, ines.mascarenhas{at}

High-output cardiac failure is rare in newborns. Emergent diagnosis and management of this pathology is crucial. We report the case of a child, currently 12-months old; obstetric background is non-contributory. Clinic observation on D1 was normal except for the presence of a systolic cardiac murmur; cardiological evaluation revealed mild ventricular dysfunction of the right ventricle. On the third day of life, she developed cardiac failure with gallop rhythm, hepatomegaly and a murmur in the anterior fontanel; an echocardiogram confirmed clinic aggravation with biventricular dysfunction and right cavities and superior vena cava dilatation. The cranial MRI confirmed the presence of a pial arteriovenous malformation (AVM) involving the anterior and middle cerebral arteries with an associated fronto-parietal ischaemic lesion. The infant underwent embolisations of AVM with successful flow reduction and cardiac failure improvement. The multidisciplinary follow-up showed no cardiac dysfunction or permanent lesions but confirmed a severe psycho-motor delay and left hemiparesia.


  • Competing interests None.

  • Patient consent Obtained.

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