Heart Failure

Question 1

What is pediatric heart failure

Answer 1

Paediatric Heart Failure (PHF) is a clinical syndrome
characterized by typical symptoms and signs
associated with specific circulatory, neurohormonal
and molecular abnormalities.
• Occurs when the heart is unable to deliver
adequate cardiac output to meet metabolic
demands of the body

Question 2

Describe the etiology of congenital heart disease

Answer 2

Congenital heart diseases
• Left to right shunts (volume overload)
• Valvular regurgitation
• Outflow tract obstruction (pressure overload)
• Coronary insufficiency
• Cardiomyopathies
• Inherited or acquired
• Arrythmias
• Systolic dysfunction
• Infection
• Systolic dysfunction
• High output states
• Volume overload
• Thyrotoxicosis
• Severe anaemia
• Systemic AV fistuli

Question 3

Describe the clinical presentation of heart failure in infants and young chikdren

Answer 3

Difficulty feeding
• Diaphoresis
• Cyanosis
• Sinus tachycardia

Question 4

Clinical presentation of heart failure in older children and adolescence

Answer 4

• Fatigue, SOB, tachypnea, exercise intolerance
• Pitting edema, oliguria, ascites

Question 5

Clinical examination

Answer 5

General appraisal
• Vital signs
• Pulse, BP, Sats, Temp, RR,
• Peripheral signs
• Cyanosis, Anaemia, Clubbing, Edema,Dehydration
Lymphadenopathy, signs of infective endocarditis,
Jaundice
• Anthropometry
• Height/length, weight, BM
Cardiovascular examination
• Inspection
• Chest deformities, precordial activity, scars
• Palpation
• All pulsations, thrills, heaves
• Apex beat
• Percussion
• Cardiac dullness & liver span
• Auscultation
• Heart sound, added sounds (murmurs, clicks, rubs)

Question 6

What are Congenital Heart Diseases

Answer 6

Congenital heart defects (CHDs) are conditions that
are present at birth and can affect the structure of
a baby’s heart and the way it works.

Question 7

Describe the etiology of chd

Answer 7

• Mostly unknown (85-90%)
• Known causes
• Multifactorial
• Environmental and genetic
• Maternal factors
• IDM, Lithium intake, lupus, age, Rubella
• Chromosomal abnormalities
• Trisomies, Turner syndrome,etc

Question 8

What is Ventricular Septal Defect

Answer 8

• One of the commonest CHD
• Left to right shunt
• Acyanotic
• Complications
• Pulmonary hypertension
• Cor pulmonale