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Permanent Non-Insulin Dependent Diabetes Mellitus after Congenital Transient Neonatal Diabetes

Discussion Cardiac failure occurs late in the natural history of aortic stenosis and the prognosis of patients so affected is poor with medical management once it develops (2). Features of left ventricular failure predominate while right heart failure is rare presumably because the patient's death soon after onset of symptoms precludes its development. However, right heart failure may dominate the clinical presentation as in our two cases. In both of these cases severe pulmonary hypertension, which has the effect of averting pulmonary oedema at the expense of producing right heart failure, was present. Pulmonary hyperScott Med J 1986;31: 041·042