Definition

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:

• Right side heart failure—will slow blood flow to the lungs. Blood may also build up in the right side of the heart. This will lead to a backup of blood into the veins.
• Left side heart failure—slows flow of blood out of the heart and to the body. Blood may also build up in the left side of the heart. It will then lead to a backup of blood into the lungs.

If fluid has backed up in the body or lungs it is called congestive heart failure. A person can also have failure on both sides of the heart. In time, the poor flow of blood will damage other organs like the kidneys.

Blood Flow through the Heart Copyright © Nucleus Medical Media, Inc.

Causes

Heart failure in children is often caused by a problem with how blood moves through the heart. The heart muscle has to work harder than normal to make blood flow. This may be caused by birth defects, such as:

• Holes in the wall of the heart
• Leaky heart valves
• Abnormal connections between blood vessels

Heart failure may also be caused by a problem with the heart itself. This is not common in children. This type of heart failure may be caused by:

• Cardiomyopathy—enlargement of the heart muscle that makes it weaken and results in less room for blood to flow
• Damage to the heart tissue from problems like:
  • A heart infection
  • Health issues, such as Kawasaki
  • Medicine, such as chemotherapy

In some children, the cause is not known.

Risk Factors

Things that may raise the risk of this problem are:

• Problems with the structure of the heart or blood vessels
• Recent bacterial or viral infection
• Weak or damaged heart muscle
• Treatment with certain medicine
• Injury to the heart (rare)

Symptoms

Problems can vary and can be mild to severe.

If blood is backing up in the right side of the heart, it can cause swelling in places such as the feet, ankles, lower legs, belly, or eyelids. If blood is backing up in the left side of the heart, it can make it hard to breathe.

Other problems may be:

• Fast breathing
• Shortness of breath
• Tiring easily
• Needing rest breaks often during activity
• Slowed or stopped growth
• Nausea or vomiting
• Sweating more than usual

Newborns may also have problems with feeding.

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical will be done.

Blood and urine tests will be done to look for signs of heart failure.

The heart may be examined. This can be done with:

• An ECG to check the electrical activity of the heart
• Exercise stress test to see how the heart responds to physical demands
• Echocardiogram to look at the heart and its structures
• Chest x-ray to look for signs of fluid backing up in the lungs
• Cardiac catheterization—catheter passed to the heart to get images of blood vessels

Treatment

The cause will need to be treated. It may stop or slow heart failure.

Supportive care may also be needed to manage health problems, such as:

Prevention

There are no known guidelines to prevent this health problem.