Heart failure living in children

Overview

Heart failure in children means the heart is not pumping blood as well as it should. This does not mean the heart has stopped. It is a long-term condition where the heart's pumping ability is weaker than normal, making it harder for the body to get the oxygen and nutrients it needs.

Heart failure in children is rare compared to adults, but it does happen. Each year, a small number of children are diagnosed with this condition.

It can affect children of any age, from newborns to teenagers. It is most often seen in children with congenital heart defects, but it can also develop after illnesses that damage the heart, such as infections or certain genetic conditions.

Symptoms

Common symptoms

• Tiredness or feeling weak
• Shortness of breath (especially during activity or when lying down)
• Swelling (edema) in the legs, ankles, or tummy
• Coughing or wheezing

Symptoms in children

• Poor feeding or trouble sucking during feeding (in infants)
• Slow weight gain or poor growth
• Excessive sweating, especially during feeding or crying
• Irritability or being unusually sleepy

Symptoms in older adults

• Shortness of breath, swelling in the legs, and tiredness are common in older adults, but this article focuses on children.

Causes

Main causes

• Congenital heart defects (heart problems present at birth)
• Cardiomyopathy (disease of the heart muscle)
• Myocarditis (inflammation of the heart muscle caused by an infection)
• Arrhythmias (irregular heartbeats that strain the heart)

Risk factors

• Family history of heart conditions or cardiomyopathy
• Certain genetic disorders (like Down syndrome or muscular dystrophy)
• Infections during pregnancy that affect the baby's heart
• Severe anemia or high blood pressure that goes untreated

When to see a doctor

See a doctor urgently if:

• If your child has trouble breathing, turns blue, or faints – call emergency services right away.
• If your child has sudden chest pain or severe tiredness that is not normal.

Book a routine appointment if:

• Schedule regular check-ups with your child's doctor and heart specialist (pediatric cardiologist).
• Follow the care plan for medicines and monitoring at home.

Diagnosis

Doctors diagnose heart failure by taking a medical history, doing a physical exam, and running tests. They will listen to the heart and lungs, check for swelling, and ask about symptoms.

Tests that may be done

• Echocardiogram (ultrasound of the heart to see how it is pumping)
• Chest X-ray (to check for fluid in the lungs or an enlarged heart)
• Blood tests (to look for signs of strain or infection)
• Electrocardiogram (ECG) (to check heart rhythm and electrical activity)

What to expect at your appointment

The evaluation may take several appointments. Your child may need to see a pediatric cardiologist (a heart specialist for children). The doctor will explain the results and work with you to create a care plan.

Treatment

Treatment aims to help the heart pump better, remove extra fluid, and reduce the workload on the heart. It also focuses on managing symptoms and improving the child's quality of life.

Self-care at home

• Monitor your child's weight daily – rapid gain can mean fluid buildup.
• Limit salt in your child's diet (ask your doctor for specific advice).
• Encourage light activity like play or walking, as allowed by the doctor.
• Keep a diary of symptoms and share it with the healthcare team.

Medical treatments

Doctors may prescribe medicines to help the heart pump stronger, remove extra fluid (diuretics), and lower blood pressure. Other treatments may include devices like a pacemaker to help the heart beat properly. Your child's doctor will explain the best options.

When is surgery considered?

Some children may need surgery to repair a congenital heart defect or to implant a device. In rare cases, a heart transplant may be considered. These decisions are made with the specialist team.

Living with this condition

Life with heart failure involves regular doctor visits, managing medicines, and watching for changes in your child's condition. With support, many children attend school, play, and enjoy normal activities.

Lifestyle tips

• Get enough rest – your child may need naps or breaks more often.
• Avoid very salty foods and processed snacks.
• Stay active, but follow the doctor's advice on how much and what kind of activity is safe.
• Keep up with all vaccines and check-ups to prevent infections.

Diet and exercise

A heart-healthy diet with low salt and plenty of fruits, vegetables, and whole grains is recommended. Your child should stay active within their limits – ask the doctor about what is appropriate. Swimming, walking, and gentle play are often good choices.

Mental health and emotional wellbeing

Living with a chronic condition can be stressful for both child and family. It is normal to feel worried, sad, or frustrated. Talk about these feelings with your healthcare team, and consider seeking support from a counselor or support group.

Prevention

Some causes of heart failure in children cannot be prevented, such as congenital heart defects. However, a healthy lifestyle during pregnancy (avoiding alcohol, smoking, and infections) can lower the risk. Proper care of infections and other health conditions in children can also help prevent heart damage.

Vaccines

Keeping your child up to date on all recommended vaccines, including the flu vaccine, is important to prevent infections like influenza that can worsen heart failure. Ask your doctor about other vaccines, such as the pneumococcal vaccine.

Screening programmes

Prenatal ultrasound screening can detect some heart problems before birth. If there is a family history, genetic counseling may help. After birth, routine check-ups can catch problems early.

Complications

If left untreated

• Worsening symptoms like severe shortness of breath or swelling
• Fluid buildup in the lungs or other organs
• Damage to the kidneys, liver, or other organs
• Arrhythmias (irregular heartbeats) that can be dangerous

Long-term outlook

With early diagnosis and proper treatment, many children with heart failure grow up to lead fulfilling lives. New medicines and treatments continue to improve outcomes. While it is a serious condition, there is much hope and support available.

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