Occult pulmonary artery is an uncommon cardiovascular defect. Associated symptoms include recurrent pulmonary infections and congestive heart failure. The authors describe a one-year-old boy initially diagnosed as having broncho- pulmonary dysplasia who developed severe failure to thrive, recurrent pneumo nias, and pulmonary hypertension. The presence of an occult right pulmonary artery was suspected by lung perfusion scan and diagnosed by cardiac catheteri zation and angiography. After surgical repair, his clinical course improved and his growth and development were normal. This case demonstrates the impor tance of including occult pulmonary artery in the differential diagnosis of in fants with failure to thrive associated with recurrent pulmonary infection.
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