by Michael Jubinville, MPH
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.
Heart failure in kids is often caused by a problem with how blood moves through the heart. The heart muscle is has to work harder than normal to make blood flow. This may be caused by birth defects such as:
A less common cause in kids is a problem with the heart itself. Disease or damage to the heart muscle can make it hard for the heart to pump well. This type of heart failure may be caused by:
In some children, the cause may be unknown.
Factors that may increase a child’s chances of heart failure include:
Symptoms can vary and can be mild to severe.
If blood is backing up in the right side of the heart, it can cause swelling. The feet, ankles, lower legs, belly, or eyelids can all be affected.
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 past health. A physical exam will be done. Your child’s doctor will check blood pressure and heart rate.
The doctor may suspect a heart problem based on exam. Tests that help to make a diagnosis include:
Other tests that may help to find the cause or severity include:
Treatment depends on the cause and severity. The goal is to help the heart work as well as possible and avoid future problems.
The cause will need to be treated. It may stop or slow heart failure.
Treatment may also be needed to support the child. Symptoms can be managed with:
Medicines may help decrease the workload on the heart. Options may include:
Oxygen (O2) therapy will increase the amount of oxygen in the blood. This will increase the amount of O2 in the body without increase work for the heart. Oxygen therapy may include:
Devices may help to support the heart. They will need to be placed in the body. Options include:
If other treatment don't work, 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
Heart failure in children and adolescents. American Heart Association website. Available at:
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Updated May 31, 2017. Accessed January 9, 2019.
Hsu DT, Pearson GD. Heart failure in children. Part I: History, etiology, and pathophysiology. Circulation: Heart failure. 2009;2:63-70. Available at:
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Mechanical circulatory support for heart failure. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 9, 2018. Accessed January 9, 2019.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods MD, FAAP
Last Updated: 1/8/2019
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