Congestive Heart Failure (CHF)What is congestive heart failure (CHF)?
Congestive heart failure (CHF) is a condition in which the heart cannot
pump enough oxygenated blood to meet the needs of the body's other organs.
The heart keeps pumping, but not as efficiently as a healthy heart.
Usually, the loss in the heart's pumping action is a symptom of an
underlying heart problem.
What causes congestive heart failure?
Congestive heart failure often occurs in children with congenital (present
at birth) heart defects. Other medical problems that can cause CHF
include, but are not limited to, the following:
- heart valve disease caused by past rheumatic fever or other
infections
- infections of the heart valves and/or heart muscle (i.e.,
endocarditis)
- cardiac arrhythmias (irregular heartbeats)
- cardiomyopathy, or another primary disease of the heart muscle
- chronic lung disease
- anemia
- high blood pressure (hypertension)
- hemorrhage (excessive bleeding)
How does congestive heart failure affect the body?
Congestive heart failure can affect the right side of the heart, the left
side of the heart, or both sides.
When the right side of the heart begins to function less efficiently,
it is unable to pump much blood forward into the vessels of the lungs.
Because of the congestion in the right side of the heart, blood flow
begins to back up into the veins. Eventually, swelling is noticed in the
feet, ankles, eyelids, and abdomen due to fluid retention.
When the left side of the heart fails, it is unable to pump blood
forward to the body efficiently. Blood begins to back up into the vessels
in the lungs, and the lungs become stressed. Breathing becomes faster and
more difficult. Also, the body does not receive enough blood to meet its
needs, resulting in fatigue and poor growth.
What are the symptoms of congestive heart failure?
The following are the most common symptoms of CHF. However, each child may
experience symptoms differently. Symptoms may include:
- visible swelling of the legs, ankles, eyelids, face, and
(occasionally) abdomen
- fast breathing during rest or exercise
- shortness of breath or labored breathing
- fatigue
- a child needing to take frequent rest breaks while playing with
friends
- nausea
- falling asleep when feeding or becoming too tired to eat
- lack of appetite
- weight gain, even when the appetite is poor
- cough and congestion in the lungs
- sweating
The severity of the condition and symptoms depends on how much of the
heart's pumping capacity has been affected.
The symptoms of CHF may resemble other conditions or medical problems.
Always consult your child's physician for a diagnosis.
How is congestive heart failure diagnosed?
Your child's physician will obtain a complete medical history and physical
examination, asking questions about your child's appetite, breathing
patterns, and energy level. Other diagnostic procedures for CHF may
include:
- blood and urine tests
- chest x-ray - a diagnostic test which uses invisible
electromagnetic energy beams to produce images of internal tissues,
bones, and organs onto film.
- electrocardiogram (ECG or EKG) - a test that records the
electrical activity of the heart, shows abnormal rhythms (arrhythmias or
dysrhythmias), and detects problems with the heart muscle.
- echocardiogram (echo) - a noninvasive test that uses sound
waves to produce a study of the motion of the heart's chambers and
valves. The echo sound waves create an image on the monitor as an
ultrasound transducer is passed over the heart.
Treatment of congestive heart failure:
Specific treatment for CHF will be determined by your child's physician
based on:
- your child's age, overall health, and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or
therapies
- expectations for the course of the disease
- your opinion or preference
If heart failure is caused by a congenital (present at birth) heart
defect or an acquired heart problem such as rheumatic valve disease,
surgical repair of the problem may be necessary. Medications are often
helpful in treating CHF initially. Eventually, medications may lose their
effectiveness and many congenital heart defects will need to be repaired
surgically. Medications may also be used after surgery to help the heart
function during the healing period.
Medications that are commonly prescribed to treat CHF in children
include the following:
- digoxin - a medication that helps strengthen the heart
muscle, enabling it to pump more efficiently.
- diuretics - helps the kidneys remove excess fluid from the
body.
- potassium-sparing diuretics - helps the body retain
potassium, an important mineral that is often lost when taking
diuretics.
- potassium supplements - replaces the potassium lost when
taking diuretics.
- ACE (angiotensin-converting enzyme) inhibitors - dilates the
blood vessels, making it easier for the heart to pump blood forward into
the body.
For more specific information regarding treating CHF, consult your
child's physician.
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