Congestive Heart Failure - Signs and Symptoms of Danger


by Anita K. Myers

Congestive heart failure (CHF) is the inability of the heart to pump an adequate amount of blood needed by the body. When this occurs, there is usually a buildup of fluid in the body tissues and lungs. The heart becomes congested with blood. It does not mean the heart will stop beating.

There are a number of reasons why CHF occurs, as well as various types of failure and degrees of severity. In the newborn, CHF is commonly caused from: 1) lesions causing outflow obstruction, usually of the left side of the heart and often times associated with a hypoplastic ventricle; 2) volume overload, usually of the infants with insufficient heart valves; or 3) systemic arteriovenous fistula. Also, on occasion a premature infant with a patent ductus arteriosus, which can cause a volume overload of the left ventricle, may show signs of failure. In some children CHF may be the first indication of a cardiac disorder.

The following are symptoms commonly seen in CHF. If one or more symptoms appear it is advisable to contact the child's physician or cardiologist.

* increased heart rate (ask your child's cardiologist what is the normal resting and active heart rate for "your" child--as this will vary with age)

* increased respiratory rate, breathing faster and deeper than normal, breathlessness (again, learn what your child's normal respiratory rate should be)

* irritability, restlessness, an unexplained fussiness

* swelling, puffiness, edema (most noticeable at the hands, feet, or around the eyes; in infants the fontanel or soft spot atop the head may appear to be swollen or bulging. "Water build-up" in newborns and infants can be difficult to detect).

* sudden weight gain or poor weight gain

* decrease in appetite or feeding

* diaphoresis (excessive sweating)

* cough, congestion or wheezing

* a decrease in activity level (tiring more easily or an increase in sleep time), fatigue, listlessness

* decrease in urine output (in infants and toddlers, fewer wet diapers)

* pale, mottled or grayish appearance in skin color

Treatment of CHF may include surgery to correct an underlying heart disorder, which is found to be the primary cause of the heart failure. In many cases, medication is prescribed and closely regulated by the child's cardiologist, such as digoxin which strengthens the pumping action of the heart and regulates heart rate; diuretics, which help rid the body of excess fluids; and more recently, the use of vasodilators/ACE inhibitors, which widen blood vessels and help to reduce the work load on the heart, allowing it to pump more effectively.

Even though most cases of CHF are managed easily, if left untreated it can be fatal.