Common Causes of Heart Failure in Children
Age at Onset | Causes |
|---|---|
In utero | Chronic anemia with subsequent high-output heart failure Large systemic arteriovenous fistulas (eg, cerebral vein of Galen shunt) Myocardial dysfunction secondary to myocarditis Sustained intrauterine tachycardia |
Birth through first few days | Any of the above Critical aortic stenosis or critical coarctation Ebstein anomaly with severe tricuspid and/or pulmonic regurgitation Hypoplastic left heart syndrome Intrauterine or neonatal paroxysmal supraventricular tachycardia Metabolic disorders (eg, hypoglycemia, hypothermia, severe metabolic acidosis) Neonatal sepsis Perinatal asphyxia with myocardial damage Severe intrauterine anemia (hydrops fetalis) Total anomalous pulmonary venous return with severe obstruction (usually infracardiac type) |
Up to 1 month | Any of the above Coarctation of the aorta, with or without associated abnormalities Complete heart block with or without associated structural heart anomalies Large left-to-right shunts in preterm infants (eg, patent ductus arteriosus) Transposition of the great arteries with a large ventricular septal defect |
Infancy (especially 6 to 8 weeks) | Bronchopulmonary dysplasia (right ventricular failure) Complete atrioventricular septal defects Rare metabolic disorders (eg, glycogen storage disease type II, also called Pompe disease) Single ventricle Supraventricular tachycardia |
Childhood | Acute cor pulmonale (caused by upper airway obstructions such as large tonsils) Acute rheumatic fever with carditis Acute severe hypertension (eg, with acute glomerulonephritis) Total anomalous pulmonary venous return (unobstructed) Bacterial endocarditis Chronic anemia (severe) Iron overload due to altered iron metabolism (hereditary hemachromatosis) or due to frequent transfusions (eg, for thalassemia major) Nutritional deficiencies Valvular heart disorders due to congenital or acquired cardiac disease (eg, rheumatic fever) Viral myocarditis Volume overload in a noncardiac disorder |