Categories: Paediatrics

Heart Failure in Children: All you need to know

Understanding Heart Failure:

The function of a healthy heart is to pump blood and maintain optimal blood flow throughout the body. Heart failure in a child occurs when the organ fails to function normally. This means that a sufficient amount of oxygenated blood does not reach the vital body tissues and it may be leaking back up into the lungs. This absence of regular blood circulation makes the heart work harder leading to heart failure.

What Causes Heart Failure in Children?

Congenital heart defects are the most common reason for heart failure in children. The primary causes of child heart failure include:

  • Hole in the heart wall or septum separating the heart’s left and right chambers
  • Malformation of one or more heart valves
  • Low RBC count or Anemia
  • Enlargement of the heart muscles
  • Irregular heartbeat or arrhythmia
  • Microbial infections
  • Side-effects of cancer medications


 Heart failure in babies symptoms differs from patient to patient. The common symptoms include:

  • Swelling (edema) of the feet, ankles, lower legs, abdomen, liver, and neck veins
  • Breathing trouble
  • Excessive fatigue
  • Over sweating tendencies
  • Weight loss and difficulty in feeding
  • Fainting
  • Chest pain

Risk Factors:

Several risk factors and complications can arise due to baby heart failure. They are:

  • Pulmonary hypertension – High blood pressure in the blood vessels connecting the heart and lungs
  • Arrhythmia – The irregular rhythm of heartbeats
  • Blood clots – This may be fatal if clots block the blood supply to the brain leading to a stroke.
  • Kidney or liver damage
  • Anemia – low hemoglobin level in the blood
  • Poor growth and development of the child

Diagnosis of Heart Failure in Children:

Pediatric cardiologists prescribe the following tests for the diagnosis of heart failure in a child:

  • Physical examinations
  • Blood and urine tests
  • Electrocardiography
  • Echocardiography
  • Cardiac catheterization


Heart failure in a child is treated depending on how serious the symptoms are. In some cases, medications are enough whereas some types of child heart failure need to be operated to fix the defects. In children with congenital heart diseases, surgical procedures are done at infancy itself.

Medicines for baby heart failure should include the following drugs:

  • Digoxin – Restores regular rhythm of heartbeats
  • Diuretics or Water pills – Assists the kidneys to get rid of extra fluid
  • Angiotensin-Converting Enzyme (ACE) Inhibitors – Lowers blood pressure, helping the heart pump blood more efficiently
  • Beta-blockers – Lowers blood pressure and heart rate

Pediatric Heart Surgery:

Pacemaker – Heart failure in children is sometimes treated with small, battery-operated devices that are placed under the skin with a wire connected to the heart. When heart failure in babies symptoms start to show, some children need these artificial pacemakers to help the heart pump blood at the normal rate.

Cardiac Resynchronization Therapy is a special type of pacemaker that is prescribed to patients who show symptoms of long-term child heart failure.

Heart failure in children caused as a result of congenital defects requires invasive surgery at infancy. Such procedures include:

  • Catheter-based heart valve procedures to fix damaged heart valves.
  • Radiofrequency ablation – short bursts of radio waves are directed to the area of the heart that is causing rapid heartbeat. This helps to correct abnormal heart rhythm in cases of baby heart failure.
  • Heart transplant – if the heart muscle function continues to deteriorate despite the prescribing of all available treatments and therapies.

Outlook and Prognosis:

The prognosis for children with heart failure depends on how well they respond to medicines, surgery, and post-surgical treatments. It is also dependent on the age of the child and the severity of symptoms. Long-term outlook should involve:

  • Administration of routine medications
  • Regular follow-ups with the cardiologist
  • Monitored periods of physical activity and exercise
  • Adding nutritional supplements in daily meals

Heart Failure in Children FAQs:

  • When should you call the child’s doctor?

Occurrences of heart failure in babies symptoms like breathing trouble, edema, and excessive fatigue are indications of the heart condition getting serious which means you should call the pediatric cardiologist immediately.

  • What causes heart failure in children?

The most common cause of child heart failure is congenital heart defects which refer to the deformation of the heart muscles right from birth.

  • What is the prognosis for baby heart failure?

With proper medical care and a healthy lifestyle, children can live near-normal lives.

Early treatment is the main answer to preventing the most serious cases of heart failure in children. As newer medicines and techniques become available, infants diagnosed with child heart failure often go on to live healthy lives as an adult.

Dr. Nagamalesh U M, Senior Consultant – Cardiology – Adult, Heart Transplant, M S Ramaiah Narayana Heart Centre, M S Ramaiah Nagar

Narayana Health

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