[Arterial fontanel pulsation].

Abstract

Infants with bounding arterial pulses frequently show a visible or palpable arterial pulsation of the fontanel. This simple clinical sign is neither described in the textbooks nor mentioned in connection with congenital heart diseases (CHD). To investigate its significance 501 infants were examined 178(35,5%) showed an arterial pulse of the fontanel. Out of 421 with no sign of cardiovascular malformation or disease on physical examination, 111(26,4%) had a fontanal pulse (f.p.). Out of 80 infants with CHD, 67(83,8%) exhibited a fontanel pulse (f.p.), while only 13(16,2%) did not. All infants with CHD had an ECG and biplane chest x-rays taken. In some of them also cardiac catheterization and heart or vessel surgery were performed. 23(79,3%) of 29 infants with PDA and eight of twelve with a VSD had a f.p.. Since other cardiac diagnoses were encountered less frequently, their relation to the presence or absence of f.p. could not be evaluated. From the variety of diagnoses, however, it became obvious that not only lesions with "early aortic runoff" may be accompanied by a f.p. Other clinical features like blood pressure, hemoglobin content and body temperature were discussed as possible causes of f.p.. Only the first mentioned, a high systemic pressure, was frequently accompanied by f.p.. Since the percentage of infants with f.p. and CHD was relatively high (37,6%) this clinical sign is considered to be of some value in the early detection of heart disease in infancy.