Heart failure in infants and children

Overview & Definition

Heart failure in a child is a clinical syndrome in which the heart cannot deliver enough blood to meet the body's metabolic demands, or can do so only at abnormally high filling pressures. It is not a single diagnosis: it is the end result of many different problems, and the whole skill of paediatric heart failure lies in finding the mechanism that is failing. [3]

Because cardiac output is the product of stroke volume and heart rate, anything that reduces stroke volume — a failing pump, a volume load that dilates the ventricle, or a pressure load that stiffens it — produces the same syndrome of poor perfusion and congestion. In adults heart failure is usually the consequence of coronary disease and a stiff, aging myocardium; in children it is usually the consequence of a structural congenital lesion or an intrinsic cardiomyopathy, which is why so much of childhood heart failure is surgically curable once the cause is found. [3] [4]

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