5.2 Heart failure
Causes of congestive heart failure1–4
Most cases of congestive heart failure in childhood result from congenital heart defects.


Age-based
One day to one week of age
Left heart obstruction in duct-dependent lesions, e.g. aortic stenosis, coarctation of the aorta.
Large left-to-right shunt lesions, e.g. large VSD, AVSD, truncus arteriosus.
Clinical manifestations and investigations1–4
General features
Investigations
Routine
Management1–3,5–15
Acute management
Diuretics
Digoxin
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3 Abelson W.H., Garth Smith R. Residents handbook of pediatrics, 7th ed. Toronto: The Hospital for Sick Children, Toronto, Canada, BC Decker Inc; 1987.
4 Guzman M.F., Hedley Brown A., Been M., et al. Manual of cardiorespiratory critical care. Sevenoaks, Kent: Butterworth; 1989.
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12 Shaddy R.E. Beta-adrenergic receptor blockers as therapy in pediatric chronic heart failure. Minerva Pediatr. 2001;53(4):297-304.
13 Shekerdemian L. Nonpharmacologic treatment of acute heart failure. Curr Opin Pediatr. 2001;13(3):240-246.
14 De Luca L., Colucci W.S., Nieminen H.S., et al. Evidence-based use of levosimendan in different clinical settings. Eur Heart J. 2006;27:1908-1920.
15 Egan J.R., Clarke A.J.B., Williams S., et al. Levosimendan for low cardiac output: A pediatric experience. J Intensive Care Med. 2006;21(3):183-187.
Allen H.D., Driscoll D.J., Shaddy R.E., et al. Moss and Adams’ heart disease in infants, children and adolescents, 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Archer N., Burch M. Paediatric cardiology. An introduction. London: Chapman & Hall Medical; 1998.
Park M.K. Congestive heart failure. In Park M.Y., editor: Pediatric cardiology for practitioners, 5th ed., Philadelphia: Mosby Elsevier, 2008.