Tuberculosis and congenital cyanotic heart disease

In an attempt to ascertain the incidence of pulmonary tuberculosis among patients with congenital cyanotic heart disease, we have reviewed the roentgenograms of the chest of 800 patients who were submitted to operation for pulmonary stenosis. Thirty-nine of these patients presented radiologic findings consistent with pulmonary tuberculosis. Further study of these thirty-nine patients, including tuberculin tests, excluded tuberculosis in twenty-four instances. In the 800 patients the maximal possible incidence of tuberculosis by these criteria is less than 2 per cent. The experimental work on aggravation of induced pulmonary tuberculosis by circulatory alteration in the lung is reviewed. In the light of this work we have briefly discussed the most suitable operative procedures for correction of congenital cyanotic heart disease complicated by pulmonary tuberculosis. The recommendations are illustrated by two detailed case reports.