How is Heart Failure Diagnosed in Children?

Diagnosis

To diagnose congenital heart failure in a child or teen, a doctor may perform a physical examination and inquire about their symptoms and health history. You and your child may be referred to a pediatric cardiologist who can order the following tests:

  • Blood and urine tests - Irregular results on these tests can indicate heart issues
  • Chest X-rays - An X-ray image can reveal problems in the heart and lungs including an enlarged heart and congestion in the lungs
  • Echocardiogram - This imaging test uses sound waves to create an image and evaluate the chambers and valves of the heart
  • Electrocardiogram (EKG or ECG) - An electrocardiogram test records the heart’s activity. It can detect abnormal heart rates and rhythms.
  • Cardiac catheterization - A small tube is placed into the heart via the blood vessels in the neck or the groin to measure pressure, blood flow, and oxygen levels in the heart and lungs
  • Heart tissue biopsies - These can be obtained during a cardiac catheterization and can help determine an underlying cause of heart failure
  • Exercise stress testing – During these tests, a patient may be asked to exercise on either a treadmill or stationary bike can help diagnose problems with the heart, lungs, or muscles

How is Heart Failure Treated in Children?

Treatments

Treatments for heart failure in pediatric patients can vary depending on the underlying cause, specific symptoms, the child’s age, and their current health status. Typical solutions include medications, surgical procedures, and non-surgical options.

Medication

Medication is frequently used to treat pediatric heart failure. Types of medication can include:

  • ACE (angiotensin-converting enzyme) inhibitors and Angiotensin receptor blockers (ARBs) help lower blood pressure and open the blood vessels, making it easier to for the heart to pump blood
  • Entresto is a recently approved drug that is a combination of an ARB and neprolysin inhibitor which also helps the heart to function more efficiently
  • Digoxin can help regulate rhythms and help the heart beat stronger
  • Diuretics (water pills) assist the kidneys in removing excess fluid from the body
  • Beta blockers help lower blood pressure and heart rate, so the heart can more effectively pump blood to the body
  • Sildenafil helps to lower pressure in the lungs, thus allowing the right side of the heart to pump more effectively, and it also has benefits on the relaxation of the left side of the heart as well

Surgical options

Some children with heart failure may require surgical procedures. These interventions may include implanting a pacemaker to deliver electrical impulses to the heart muscle and/or a defibrillator, which can deliver an electrical impulse to rescue the heart from a dangerous arrhythmia.

Some patients may require a ventricular assist device (VAD) to pump the heart’s blood. VADs can support the left side of the heart, the right side of the heart, or both.

In cases of severe heart failure, a child may need a heart transplantation or heart and lung transplantation from a healthy donor.

Nonsurgical options

To keep the heart healthy, you and your child may work with a nutritionist to help with feeding and management of fluids. Your doctor may also recommend an exercise program or other forms of physical therapy.

Pediatric treatments and interventions can differ from treatments for adult heart failure.

FAQs

FAQs

The most common cause of heart failure in children and infants is a congenital heart defect, a condition present at birth.

Congestive heart failure is most commonly caused by a congenital heart defect (CHD). In the United States, there are around 40,000 babies born with CHD every year.
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Trust NewYork-Presbyterian for Pediatric Heart Failure Treatment

At NewYork-Presbyterian, we offer the highest quality of care for infants, children and teenagers with congestive heart failure symptoms. Our compassionate team of heart failure specialists includes cardiologists, cardiac surgeons, nurse practitioners, and nurse coordinators who collaborate with nutritionists, pharmacists, social workers, and physical therapists to treat the whole child.

For the highest standards in pediatric heart care, contact NewYork-Presbyterian today.