CLINICAL CONFERENCE

Interest in aortic stenosis has recently been greatly enhanced because of the surgical advances in its alleviation. The following 4 cases are presented to illustrate some of the problems in diagnosis and treatment of this lesion and to record 2 unusual pathologic variants. Case 1. J.S. (HLH Niumber A-96356), a white girl, was observed in the Cardiac Clinic of the Harriet Lane Home from the age of 13 months until her death at the age of 51/2 years. The family history was not pertinent. There were no siblings. The patient was born at full term; birth weight was 6 pounds, 14 ounces. A heart murmur as well as unusual facies and webbed neck were noted at birth. Her psychomotor devel-opment was retarded; she was not able to sit up even with support until the age of 12 months; she began to walk only at the age of 2 years and she did not use words until the age of 31/2 years. Her past medical history was negative. The only car-diac symptoms noted by the parents were slig-ht dyspnea, fatigue, and duskiness around the lips and nose after exertion. Physical examination at 15 months revealed an average-sized, mentally retarded child. The face was unattractive: the nose was broad and up-turned, there were bilateral slight ptosis of the eyelids, a suggestion of micrognathia, and minimal bilateral webbing of the neck. There was marke