Pediatric Heart Failure

What Causes Heart Failure?

There are three main causes of heart failure:

• An underlying cardiomyopathy, which is a problem with heart muscle itself. There are different types of cardiomyopathy. Cardiomyopathy can cause the heart to pump poorly or keep it from filling with blood normally. Some cardiomyopathies are inherited through families.
• A congenital heart disease (CHD) that causes structural problems in the heart. CHD can affect how well the heart squeezes or can cause leaky valves. These issues can lead to the heart not being able to pump blood as well as it should.
• An infection that causes the heart to enlarge or not squeeze well.

Other less common causes of heart failure can include:

• Cardiac arrhythmias or abnormal heart rhythms
• High blood pressure
• Lung disease
• Medication side effects (e.g. chemotherapy)

Heart failure is sometimes called “Congestive” refers to the lungs and other tissues in the body becoming filled with fluid — part of a chain reaction of blood not being pumped properly.

What are Heart Failure Symptoms?

Typical heart failure symptoms can include:

• Shortness of breath/trouble breathing
• Abnormally fast breathing
• Swelling in the legs, ankles and face
• Feeling of tiredness (that can’t be explained by something else)
• Poor feeding or growth (babies)
• Feeling nauseous when eating or lack of appetite (older children)
• Excessive sweating when feeding or playing
• Rapid weight gain (usually with poor appetite and is due to retaining fluid)

In children without a known heart diagnosis, heart failure can be difficult to recognize. The symptoms can mimic other conditions, or be slowly progressive. Children can compensate for decreased heart function much longer than adults.

That’s why seeing an experienced pediatric cardiologist for diagnosis is so important. Lurie Children’s cardiologists are trained to look for the more subtle symptoms of heart failure.

How Lurie Children’s Diagnoses & Treats Heart Failure

We first seek to understand your child’s symptoms and how they show up in daily life. We do a complete physical exam and take a history of symptoms and a family history.

We may then do tests to get a closer look at the heart and how it’s functioning.

These include echocardiograms or electrocardiograms, as well as more advanced imaging like cardiac computed tomography (CT) or cardiac MRI. We may do an exercise stress test or have a child wear a Holter monitor to look at their heart rhythm. We may also use cardiac catheterization, which requires anesthesia.

These tests can help find the underlying cause of the heart failure, which may tell us how to treat it. If it’s a leaky valve, for example, we can repair the valve with heart surgery.

We always start with the least invasive treatment and add options as we need. Medication is the most common treatment for heart failure. Some children may need continuous medication  while staying in our Regenstein Cardiac Care Unit for a time.

For children who need mechanical support, we offer ventricular assist devices. We have a dedicated team who specializes in the care of children who need more advanced heart support. For certain children who have severe heart failure, a heart transplant is the treatment.

Whatever the treatment, we partner with the patient and family. We’ll make sure your family understands what’s happening each step of the way.

Why Choose Lurie Children’s for Heart Failure?

Treating heart failure is a true area of strength for Lurie Children’s Heart Center. As a top ranked pediatric heart center by U.S.News and World Report, we’re known for:

• Advanced training: All our heart failure and heart transplant cardiologists have additional training related to heart failure. We see all types of heart failure and have experience with every treatment.
• Dedicated pediatric VAD program: We have an entire team dedicated to VAD, with devices to support kids and young adults of all sizes. VAD can be a life-saving option for children in heart failure.
• 30+ years of heart transplants: We’ve been a pioneer in the heart transplant community and have decades of experience in taking care of the sickest children with the heart failure.
• Active in heart failure research and clinical trials: On a regular basis, we take part in 10 - 15 active clinical research projects, aimed at improving outcomes in kids with heart failure. Lurie Children’s is a major center for heart research.