A Pioneering Heart Transplant Program

Cardiac syndromes

Congestive Heart Failure

Congestive heart failure (CHF) is an abnormal state in which the heart is not able to pump blood and oxygen at a rate that meets the body's demand, resulting in low cardiac output. Its causes are many, and include congenital and/or structural defects in the heart, vessels or muscles, pulmonary and hematologic abnormalities, renal dysfunction or advanced heart disease.

In a pediatric population, the onset of congestive heart failure can occur in the fetus, in infancy, and in school- and teen-aged children. The age of onset is key to identifying the cause. While rare, fetal CHF incidence is increasing with the use of fetal ultrasonography; it is generally caused by sustained supraventricular tachyarrhythmia with or without structural cardiac defects. Dysfunctional cardiac muscle is the most common cause of congestive heart failure in neonates and can co-occur with sepsis, hypoglycemia and hypocalcemia (deficiency of calcium in blood). Other causes in newborns include heart rate and rhythm abnormalities, systemic congenital arterio-venous failure and tricuspid valve regurgitation (TR). Structural abnormalities present at birth often become apparent within days or weeks.

Congestive heart failure in children and teens as a new condition is uncommon. CHF is generally the result of an uncorrected congenital condition that has existed since infancy, or from complications post-surgery to correct abnormalities. Sometimes it is the natural progression of an existing condition. Rheumatic mitral disease and aortic valve disease can lead to CHF in young adults.