Congestive heart failure affects people of all ages. When the heart doesn’t pump blood the way it should, the body doesn’t receive enough oxygenated blood and fluid builds up in the lungs or tissue causing congestion. Without treatment, a child who suffers from congestive heart failure may experience lung problems, organ failure or other serious conditions. Effective treatments for congestive heart failure are available, however, the underlying cause should be also identified and treated to best protect your child’s health

Wellness & Prevention

For some children, congestive heart failure may be caused by heart defects they were born with, such as aortic stenosis, atrioventricular canal defect or atrial septal defect. These defects can alter how blood flows through the heart and push a higher volume of blood through one side, causing half of the heart to weaken and fail to pump adequate blood to the body. Congestive heart failure can also be caused by hypertrophic cardiomyopathy and cardiac arrhythmia, which affect how the heart pumps blood.

Congestive heart failure can be caused by many other health conditions, too, including an overactive thyroid, high blood pressure, a viral infection, chronic lung disease, heart valve disease and an enlarged heart.

One or both sides of the heart can be impacted by congestive heart failure. If function is affected in the right side of the heart, blood can’t be effectively forced into the lungs’ vessels and blood can back up in the veins as the heart becomes congested. The lower legs, feet, ankles, abdomen and eyelids can swell as fluid is retained. If the left side of the heart fails, blood can’t be pumped efficiently into the body and may back up in the lungs, stressing the lungs and causing fast, difficult breathing. As a result, the body does not receive adequate oxygenated blood and children may feel fatigued or not grow properly.

Children may experience congestive heart failure differently but symptoms can include:

  • Sweating
  • Weakness or tiredness
  • Swelling in the face, abdomen, ankles or feet
  • Shortness of breath or abnormally fast breathing
  • Nausea
  • Lack of appetite
  • Falling asleep when eating or seeming too tired to eat
  • Cough and lung congestion
  • Failure to gain weight
  • Wheezing
  • Racing heartbeat

Older children may also lose weight, faint, feel chest pain and tire easily during exercise.

Congestive heart failure symptoms may resemble other conditions. Talk to your child’s doctor and see a pediatric cardiologist for a diagnosis.


A pediatric cardiologist may start by taking a full medical history, conducting a physical examination and asking questions about possible symptoms, such as your child’s eating, breathing and activity level. There are several different tests your child’s cardiologist can use to help diagnosis congestive heart failure.

  • Lab tests: Blood and urine tests can be used to evaluate how the kidneys and other organs are working.
  • Chest X-ray: An X-ray of your child’s chest produce an image that shows the size and shape of the heart and if fluid is in the lungs.
  • Electrocardiogram (ECG or EKG): Electrocardiograms are used to record the electrical activity in the heart. An ECG can show abnormal rhythms, issues with the heart’s structure and stress on the heart.
  • Echocardiogram: Using an ultrasound, an echocardiogram creates an image of the heart that lets your child’s doctor assesses the heart’s function and structure, including details about how blood flows and how well the heart pumps.
  • Cardiac catheterization: A tiny catheter can be inserted through a larger blood vessel, often in the groin, and from there threaded up to the heart to take oxygen measurements and check blood pressure. Your pediatric cardiologist can also take a biopsy during this procedure to help figure out what caused the congestive heart failure.


Treatment plans for congestive heart failure can vary based on your child’s age, health, medical history, the level of failure and the prognosis. Your pediatric cardiologist may prescribe medication, including:

  • Diuretics to help the kidneys flush excess fluid and relieve fluid build up in the lungs.
  • Digoxin to help the heart pump blood more forcefully.
  • Beta blockers to lower blood pressure and slow your child’s heart rate for more efficient pumping.
  • ACE (angiotensin-converting enzyme) inhibitors to help dilate or relax blood vessels so blood flows easier from the heart.

More invasive treatments for severe congestive heart failure may include implanting a pacemaker to treat an abnormal heartbeat or coordinate contractions or transplanting a new heart from a donor.


Because the severity of congestive heart failure can vary drastically, your pediatric cardiologist can provide the best information about your child’s outcome after treatment. Children who take medication or require surgery may be able to resume their normal activities after recovering from the affects of congestive heart failure. Regardless of the type of treatment, your pediatric cardiologist may recommend ongoing care to monitor your child’s health.