Heart failure in infants and children — branching viva

Station opening

Examiner: "Define heart failure in a child and explain why the mechanism matters more than the label." ^[3]

Strong candidate (must-hit)

• Defines paediatric heart failure as a clinical syndrome in which the heart cannot deliver adequate cardiac output, or does so only at raised filling pressure; explains that it is not one diagnosis but the end result of many mechanisms, and that the whole skill is to name the mechanism — a volume-overload shunt that is cured by closure, a pressure-load obstruction that is cured by relief, or an intrinsic pump failure that needs neurohormonal therapy and escalation — because the mechanism decides the management and, in most cases, the cure. ^{[3] [6]}

Weak candidate

• "Heart failure is when the heart doesn't pump properly, and we give diuretics." ^[3]