The observation, four years ago, of a patient with acute hemorrhagic nephritis in whom the predominating clinical manifestations were those of cardiac failure has led us to a more careful study of the status of the heart in patients with this illness. Since then, from October 1932 to October 1936, in a total of fifty-five patients with acute hemorrhagic nephritis admitted to the Children's Hospital of Philadelphia, we have observed fourteen children with varying degrees of cardiac involvement during the acute stage of their illness. Further analysis of the cases of these fifty-five patients revealed rather unexpectedly that cardiac involvement was the most frequent accompanying complication of acute hemorrhagic nephritis (table 1).
As far back as 1879 Goodhart1 demonstrated cardiac dilatation in cases of postscarlatinal nephritis. More recently Guthrie2 found cardiac hypertrophy at autopsy in seven of eight cases in which the blood pressure had been elevated during