When Your Child Has Congestive Heart Failure (CHF)

When Your Child Has Congestive Heart Failure (CHF)

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When Your Child Has Congestive Heart Failure (CHF)

Congestive heart failure (CHF) is a condition in which the heart does not pump as well as it should. When this happens, fluid can build up in the lungs or body tissues. CHF can cause lung problems, organ failure, and other serious problems in the body. CHF can usually be treated, but it is important to find out the underlying cause. Your child’s health care provider will evaluate your child’s heart and discuss treatment options with you.

What Causes Congestive Heart Failure?

CHF often develops in children with certain congenital (present at birth) heart defects. These include defects such as holes in the heart, which cause an increased amount of blood flow from one side of the heart to the other. CHF can usually also be caused by other types of heart problems, such as diseases of the heart muscle. These include problems such as cardiomyopathy, a condition in which the heart’s pumping function is impaired. Some nonheart problems, such as kidney failure, can lead to CHF. 

What Are the Symptoms of CHF?

Boy lying on exam table. Health care provider is holding echocardiogram probe on skin of boy's chest.

Symptoms vary but may include:

  • Swelling (edema) in the face, abdomen, ankles, or feet

  • Shortness of breath, rapid breathing, wheezing, or excessive coughing

  • Weakness or tiredness

  • Poor feeding and weight gain (in infants)

  • Racing heartbeat

  • Tiring easily during exercise (in older children)

  • Wheezing

How Is the Cause of Congestive Heart Failure Diagnosed?

Heart problems in children are usually diagnosed and treated by a doctor called a pediatric cardiologist. A physical exam is performed. The cardiologist also asks about your child’s health history. The following tests may be done to find the underlying cause of CHF:

  • Chest X-ray. This test takes a picture of the heart and lungs. The picture can show your child’s heart size and shape. It can show if there are problems in the heart and lungs.

  • Electrocardiogram (ECG or EKG). During this test, the electrical activity of the heart is recorded to check for arrhythmias (problems with the heartbeat) or problems with heart structure.

  • Echocardiogram (echo). During this test, sound waves (ultrasound) are used to create a picture of the heart. This test can show problems with heart structure or heart function. This includes showing how well the heart pumps, if the heart is enlarged, or if there are any valve problems.

  • Lab tests. For these tests, blood and urine samples are taken to check for problems in the kidneys or other organs.

How Is Congestive Heart Failure Treated?

  • Specific treatment for your child depends on the cause of CHF. If the cause of CHF in your child is a congenital heart defect, a catheter or surgical procedure may be the best treatment.

  • Medications are often prescribed to help manage your child’s symptoms. These can include:

    • Diuretics, which help rid the body of excess water. This reduces fluid in the lungs and may improve breathing.

    • Digoxin, which helps the heart pump blood with more force. This improves the heart’s performance.

    • ACE inhibitors, which make blood vessels relax and allow blood to flow more easily from the heart. Angiotensin receptor blockers or ARBs are very similar. 

    • Beta-blockers, which lower blood pressure and slow heart rate by altering hormones (body chemicals) that can damage the heart. Beta-blockers can also improve the heart’s pumping action over time.

What Are the Long-term Concerns?

The outcome for a child with CHF depends on many factors, including the underlying heart problem. The cardiologist will discuss your child’s condition, treatment options, and potential outcomes with you.