Large tonsils and adenoids in small children with cor pulmonale.

Abstract

Cor pulmonale as a con-consequence of chronic upper airway obstruction by hypertrophied tonsils and adenoids seems relatively common among young children in the less effluent section of society. The syndrome is sufficiently characteristic to permit rapid clinical diagnosis. Its features are noisy, labored respiratory efforts accompanied by poor pulmonary air exchange; somnolence, particularly marked in recumbency; cardiome-galy; right ventricular hypertrophy; and signs of right heart failure. Although characteristic, the severity of these signs varies directly with the degree of obstruction, at least in the early stages. Prompt relief of obstruction, either by the establishment of an adequate airway or surgical removal of the tonsils and adenoids, is indicated to avoid potentially lethal consequences. The cardiovascular findings appear to be completely reversible.