Patient
Information
Congestive Heart Failure
“Congestive heart failure” is a term we
use when the heart is having trouble doing all the work it needs
to do without causing symptoms.
It is a common occurrence among children and adults with
heart problems, and it is generally treatable.
The heart’s job is to pump enough blood
around the body at a high enough pressure to make sure every part
of the body is getting enough oxygen and nutrients.
If the heart muscle becomes weak, or the heart has more
than the usual amount of work to do, the heart can have a hard
time, resulting in congestive heart failure.
Symptoms of Congestive Heart Failure
The heart has two main pumping chambers – the right side pumps
blood coming back from the body, and the left side pumps the blood
coming back from the lungs. The
symptoms of congestive heart failure depend on which side of the
heart is having trouble. Right
heart failure causes blood to “back up” (congestion) in the
body, resulting in swelling (edema), fluid in the abdomen or chest
(ascites or pleural effusion), and enlargement of organs such as
the liver (hepatomegaly). Left
heart failure causes congestion in the lungs, resulting in rapid
or difficult breathing and, in babies, difficulty with feeding.
Both kinds of heart failure result in a faster heart rate
(tachycardia) and enlargement of the heart on x-ray.
When severe, congestive heart failure in children can
result in irritability, poor growth, dizziness or even fainting.
In newborn infants, one sign of congestive heart failure
can be marked sweating with feeding, generally combined with fast
breathing.
Treatment of Congestive Heart Failure
Often congestive heart failure can be treated by removing the
cause. A valve that is
too tight, or a large hole between two pumping chambers, might be
repaired, for example. If
it is not possible, or advisable, to remove the cause of
congestive heart failure, a child might require treatment with
medications and/or nutritional supplements.
There are several types of medications that
are useful in congestive heart failure.
Lanoxin (digoxin) helps the heart beat more strongly.
Diuretics such as Lasix (furosemide) cause the kidneys to
produce more urine, reducing the amount of fluid in the body and
helping the heart work more efficiently.
Many diuretics cause the body to lose too much potassium,
and a second medication, Aldactone (spironolactone) or a potassium
supplement, may be used as well.
A third class of medications, which includes Captoten (captopril)
and Vasotec (enalapril), causes the arteries to relax, reducing
the amount of work the heart has to do.
Occasionally there are other types of medications that are
used as well.
Children who require medical treatment for
congestive heart failure require close follow up with a pediatric
cardiologist to look for side effects of the medications, and to
ensure that the doses are correct as a child grows.
In addition to medications, some children
benefit from additional nutrition, and may be offered high-calorie
formula or nutritional supplements.
For more information about congestive heart failure, as your
cardiologist, or visit these web sites:
C.S. Mott Children’s Hospital - http://www.med.umich.edu/1libr/chheart/care02.htm
Lucile Packard Children’s Hospital - http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/chf.html
Discovery Health - http://health.discovery.com/diseasesandcond/encyclopedia/2973.html
Winnipeg Children’s Hospital - http://www.hsc.mb.ca/childrens/cf/CHF.htm
Children’s Hospital in
Boston
- http://www.childrenshospital.org/cfapps/A2ZtopicDisplay.cfm?Topic=Congestive%20Heart%20Failure
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