Discordant heart anomalies in twins.

TIE ETIOLOGY of the great majority of congenital cardiac malformations remains obscure. Certain environmental factors, such as maternal rubella (Rutstein et al, 1952, Stuckey, 1956) and anoxia (Alzamora et al, 1953), are strongly suspected of having etiological significance in humans. Support for a genetic hypothesis for congenital heart disease has arisen from an increased incidence of cardiac malformations in certain families (reviewed by Taussig, 1947). In contrast to these reports it has been noted in a number of twins seen at The Hospital for Sick Children in Toronto that only one of each pair had a malformation of the heart. A systematic investigation of all twins referred to the Cardiac Service has therefore been made.

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