Heart Failure

Question 1

What are symptoms of heart failure?

Answer 1

Breathlessness (particularly on feeding or exertion)
Sweating
Poor feeding
Recurrent chest infections

Question 2

What are signs of heart failure?

Answer 2

Poor weight gain or faltering growth
Tachypnoea
Tachycardia
Heart murmur, gallop rhythm
Enlarged heart
Hepatomegaly
Cool peripheries

Question 3

What are signs of right heart failure?

Answer 3

Ankle oedema
Sacral oedma
Ascites

Question 4

What usually causes heart failure in neonates?

Answer 4

Obstructed (duct-dependent) systemic circulation

Hypoplastic left heart syndrome
Critical aortic valve stenosis
Severe coarctation of the aorta
Interruption of the aortic arch

Question 5

What are causes of heart failure in infants?

Answer 5

High pulmonary blood flow

VSD
AVSD
Large persistent ductus arteriosus

Question 6

What are causes of heart failure in older children and adolescents

Answer 6

Right or left heart failure

Eisenmenger’s syndrome (Right heart failure only) - irreversibly raised pulmonary vascular resistance resulting from chronically raised pulmonary arterial pressure and flow - left to right shunt reverses
Rheumatic heart disease
Cardiomyopathy

Question 7

What is important in duct-dependent systemic circulation

Answer 7

Maintaining ductal patency with prostaglandins infusion