Skip to main content

Advertisement

Log in

Heart failure in children: Clinical aspect and management

  • Symposium on Advances in Cardiology - II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Heart failure (HF) is a complex syndrome, with several definitions, the commonest being “an abnormality of cardiac function whereby heart in unable to pump at a rate commensurate with the requirement of the metabolizing tissues, or does so only at elevated filling pressures”. In case of children, this requirement includes growth and development. Unlike as seen in adults, HF in children is commonly due to structural heart disease and reversible conditions. Thus the treatment for HF is commonly required for short term only. The overall outcome with HF is better in children than in adults. While the general principles on management are similar to those in adults, the evidence for the use of drugs in children is less convincing. It requires a judicious balance of extrapolation from adult medicine, keeping in mind that children are not small adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ramakrishnan S, Kothari SS, Bahl VK. Heart Failure-Definition and Diagnosis. Indian Heart J 2005; 57:13–20

    PubMed  CAS  Google Scholar 

  2. Braunwald E, Grossman W. Clinical aspects of heart failure. In Braunwald E ed. Heart Disease: A Textbook of Cardiovascular Medicine, 4th ed. Philadelphia; Saunders, 1992; 444–463

    Google Scholar 

  3. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary, A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2001; 104: 2996–3007

    Article  PubMed  CAS  Google Scholar 

  4. Sommers C, Nagel BH, Neudorf U, Schmaltz AA. Congestive heart failure in childhood. An epidemiologic study. Herz 2005;30:652–662.

    Article  PubMed  Google Scholar 

  5. Webster G, Zhang J, Rosenthal D. Comparison of the epidemiology and co-morbidities of heart failure in the pediatric and adult populations: a retrospective cross-sectional study. BMC Cardiovascular Disorders 2006;6: 23

    Article  PubMed  Google Scholar 

  6. Kay JD, Colan SD, Graham TP. Congestive heart failure in pediatric patients. Am Heart J 2001; 42:923–928

    Article  Google Scholar 

  7. Lipshultz SE, Sleeper LA, Towbin JA et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N Engl J Med 2003; 348:1647–1655

    Article  PubMed  Google Scholar 

  8. Towbin JA, Lowe AM, Colan SD et al. Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA 2006;296:1867–1876

    Article  PubMed  CAS  Google Scholar 

  9. Law YM, Keller BB, Feingold BM, Boyle GJ. Usefulness of plasma B-type natriuretic peptide to identify ventricular dysfunction in pediatric and adult patients with congenital heart disease. Am J Cardiol 2005; 95: 474–478

    Article  PubMed  CAS  Google Scholar 

  10. Ross RD, Bollinger RO, Pinsky WW. Grading the severity of congestive heart failure in infants. Pediatr Cardiol 1992; 13:72–75.

    Article  PubMed  CAS  Google Scholar 

  11. Burch M. Heart failure in the Young. Heart 2002;88:198–202

    Article  PubMed  Google Scholar 

  12. Saxena A for ’Working Group on Management of Congenital Heart Diseases in India’. Consensus on timing of intervention for common congenital heart disease. Indian Pediatr 2008;45:117–126

    Google Scholar 

  13. Keith JD, Rose V, Collins G, Kidd BS. Ventricular septal defect: incidence, morbidity, and mortality in various age groups. Br Heart J 1971; 33:81.

    Article  PubMed  Google Scholar 

  14. Saxena A, Tandon R, Shrivastava S. Clinical course of isolated ventricular sepal defect: an Indian experience. Indian J Paediatr 1993; 60:777–782

    Article  CAS  Google Scholar 

  15. Shaddy RE, Boucek MM, Hsu DT et al. Carvedilol for children and adolescents with heart failure: a randomized controlled trial. JAMA 2007;298:1171–1179

    Article  PubMed  Google Scholar 

  16. Robinson JL, Hartling L, Crumley E, Vandermeer B, Klassen TP. A systematic review of intravenous gamma globulin for therapy of acute myocarditis. BMC Cardiovasc Disord 2005;5:12

    Article  PubMed  Google Scholar 

  17. Hia CP, Yip WC, Tai BC, Quek SC. Immunosuppressive therapy in acute myocarditis: an 18 year systematic review. Arch Dis Child 2004;89:580–584

    Article  PubMed  CAS  Google Scholar 

  18. Canter CE, Shaddy RE, Bernstein D et al. Indications for Heart Transplantation in Pediatric Heart Disease: A Scientific Statement from the American Heart Association Council on Cardiovascular Disease in the Young; the Councils on Clinical Cardiology, Cardiovascular Nursing, and Cardiovascular Surgery and Anesthesia; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;115;658–676

    Article  PubMed  Google Scholar 

  19. Duncan BW, Bohn DJ, Atz AM et al. Mechanical circulatory support for the treatment of children with acute fulminant myocarditis. J Thorac Cardiovasc Surg 2001; 122:440–448.

    Article  PubMed  CAS  Google Scholar 

  20. Stiller B, Dahnert I, Weng YG, Hennig E, Hetzer R, Lange PE. Children may survive severe myocarditis with prolonged use of biventricular assist devices. Heart 1999;82: 237–240.

    PubMed  CAS  Google Scholar 

  21. Seth S, Narang R, Bhargava B, for the AIIMS Cardiovascular Stem Cell Study Group. Percutaneous intracoronary cellular cardiomyoplasty for nonischemic cardiomyopathy: clinical and histopathological results: the first-in-man ABCD (Autologous Bone Marrow Cells in Dilated Cardiomyopathy) trial. J Am Coll Cardiol 2006; 48:2350–2351

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anita Saxena.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chaturvedi, V., Saxena, A. Heart failure in children: Clinical aspect and management. Indian J Pediatr 76, 195–205 (2009). https://doi.org/10.1007/s12098-009-0050-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-009-0050-0

Key words

Navigation