Heart failure is when the heart cannot work as well as it should. Problems caused by the failure will depend on the area of the heart that is affected. For example:
If fluid has backed up in the body or lungs it is called congestive heart failure. It is also possible to have failure on both sides of the heart. The poor flow of blood will eventually also damage other organs like kidneys.
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Heart failure in children is most often caused by one of two factors. The most common problem is how the blood flows within the heart. Even though the heart muscle is healthy it has to work harder to create healthy blood flow. This may be caused by defects present at birth such as:
A second cause is a problem with the heart itself. Disease or damage to the heart muscle can make it hard for to move blood throughout the body. This type of heart failure may be caused by:
In some children, the cause may be unknown.
Factors that may increase your child’s chances of heart failure include:
Symptoms vary based on age, which side of the heart is affected, the severity, and how much damage is present.
If blood is backing up in the right side of the heart, it can cause swelling in the feet, ankles, lower legs, abdomen, or eyelids.
If blood is backing up in the left side of the heart, it can make it hard to breathe.
General symptoms of heart failure may include:
Infants may also have problems with feeding, development, and growth.
You will be asked about your child’s symptoms and medical history. A physical exam will be done. Your child’s doctor will check their blood pressure and heart rate.
The heart and surrounding structures can be assessed with:
Blood and urine tests can be done to check how other organs like the kidneys or liver are working.
Heart failure treatment depends on the cause and severity. The goal of treatment is to help the heart work as well as possible and prevent complications.
Some heart failure may be relieved with treatment of underlying conditions. This may include surgery to repair defects or time and medical support for infections.
Treatments for heart failure often include a combination of some of the following:
Medications may help decrease the workload on the heart by decreasing blood pressure, helping the heart pump better, and managing excess fluid. Medication options may include:
Slower blood flow reduces the amount of oxygen that reaches the tissue throughout the body. Oxygen therapy will increase the amount of oxygen in the blood. This way there is more oxygen available for the tissue even if the blood flow has not improved. Oxygen therapy may include:
Surgery may be needed to correct congenital heart disease or valve defects. In some cases, implanted devices may help support the heart. Some options include:
If other treatment methods fail, a heart transplant may be considered. The diseased heart is replaced with a healthy heart from a donor.
Some causes of heart failure cannot be prevented. However, there are steps you can take to prevent some causes:
American Heart Association
Healthy Children—American Academy of Pediatrics
Caring for Kids—Canadian Paediatric Society
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Heart failure in children and adolescents. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/:%2520Heart-Failure-in-Children-and-Adolescents_UCM_311919_Article.jsp#.WNvClm8rJQI. Updated October 6, 2016. Accessed March 29, 2017.
Hsu DT, Pearson GD. Heart failure in children. Part I: History, etiology, and pathophysiology. Circulation: Heart failure. 2009;2:63-70. Available at: http://circheartfailure.ahajournals.org/content/2/1/63.
Mechanical circulatory support for heart failure. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T483099/Mechanical-circulatory-support-for-heart-failure. Updated December 19, 2016. Accessed March 29, 2017.
Testing & diagnosis for heart failure in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/c/heart-failure/testing-and-diagnosis. Accessed March 29, 2017.
Treatments for heart failure in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/c/heart-failure/treatments. Accessed March 29, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods MD, FAAP