TY - CHAP M1 - Book, Section TI - Chapter 497. Heart Failure A1 - Shaddy, Robert E. A1 - Ravishankar, Chitra A2 - Rudolph, Colin D. A2 - Rudolph, Abraham M. A2 - Lister, George E. A2 - First, Lewis R. A2 - Gershon, Anne A. PY - 2011 T2 - Rudolph's Pediatrics, 22e AB - Heart failure is a complex condition with many potential causes, but with the end result that the heart is unable to meet the metabolic demands of the body (including growth in children). Many believe that there must also be a component of systemic or pulmonary congestion. However, some patients with heart failure may have no significant congestion at rest, but only develop congestion with exertion or other forms of increased oxygen demand. Heart failure is generally precipitated by an insult to the cardiovascular system, either acquired or congenital. In adults, the most common insult is ischemic coronary artery disease with resultant left ventricular dysfunction. In children, heart failure is rarely ischemic, and the causes are quite varied and age dependent; refer to Chapters 483 and 484 for specific lesions associated with heart failure in children of different ages. Although infants with large left-to-right shunts and pulmonary overcirculation are commonly referred to as being in heart failure, their ventricular performance is usually normal, and their “heart failure” is usually a manifestation of pulmonary overcirculation with or without elevated ventricular filling pressures. They may have decreased systemic blood flow as well. Severe left-sided obstructive lesions (eg, hypoplastic left heart syndrome) often present with heart failure in the newborn period because the left ventricle cannot adequately eject blood to the systemic circulation. Both of these groups of lesions are generally managed by surgery or transcatheter intervention, but symptomatic therapy is often needed prior to surgical correction SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=7049387 ER -