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CONGESTIVE HEART FAILURE

CONGESTIVE HEART FAILURE
Etiology

 

  1. congenital heart defects
  2. ateriovenous malformations
  3. cardiomyopathy
  4. arrhythmias acute hypertension anemia cor pulmonale

Pathophysiology

 

see Cardiology Notes


Symptoms

 

Infant:

 

  1. feeding difficulties,
  2. easy fatigability
  3. exertional dyspnea
  4. diaphoresis when sleeping or eating,
  5. respiratory distress
  6. vomiting
  7. lethargy
  8. cyanosis

Child:

 

  1. decreased exercise tolerance
  2. fatigue
  3. decreased appetite
  4. failure to thrive
  5. respiratory distress, syncope
  6. frequent URTIs or "asthma" episodes
  • orthopnea, paroxysmal nocturnal dyspnea, edema are uncommon in children


Physical Findings

 

  1. four key features:  (2 tachy, 2 megaly)
    • tachycardia
    • tachypnea
    • cardiomegaly
    • hepatomegaly
  2. failure to thrive
  3. respiratory distress, wheeze, crackles, cyanosis and clubbing
  4. alterations in peripheral pulses, four limb blood pressures
  5. dysmorphic features associated with congenital syndromes

Management

  1. general: sitting up, oxygen, sodium and water restriction, increased
    caloric intake
  2. pharmacologic:
    • diuretics
    • inotropic agents
    • afterload reduction
  3. correction of underlying cause

CONGESTIVE HEART FAILURE CONGESTIVE HEART FAILURE Reviewed by Radiology Madeeasy on September 05, 2010 Rating: 5
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