CARDIAC FAILURE

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Last Updated : 5/11/2016
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Valerie Schroeder
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Introduction
Heart failure continues to be a worldwide health dilemma. Heath care costs for children are higher owing to the need for surgical or catheter based interventions for congenital heart disease (1). Even though more children with heart disease are surviving into adulthood, there is still considerable childhood morbidity and mortality as well psychological stress for both the patient and family.
Understanding the pathophysiology of heart failure is equally as important as recognizing the cause and severity of heart failure. The classic definition of heart failure involves a scenario where cardiac function is inadequate to meet the body’s need for energy (2). This definition brings to mind a dilated, poorly contracting heart. However, children with congenital heart disease often have normal heart function yet exhibit classic features of heart failure. A more comprehensive definition would include cardiac dysfunction as well as pressure and volume overload (3). Moreover, the complex interactions between the diseased heart and feedback signaling from the body and circulation cannot be ignored (3). Such compensatory processes help to mask symptoms early on but complications appear as these processes fail and ironically accelerate disease. Heart failure is best approached as a systemic disease where the heart is treated and compensatory responses are subdued. The goal of this discussion is to review broad etiologies of heart failure and treatments to allow the practitioner to select targeted, diagnosis-based therapies.

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Contributor Information and Disclosures Valerie Schroeder
Pediatric Cardiology Associate Professor
University of Kansas Medical Center Department of Pediatrics
3901 Rainbow Blvd, Kansas City, KS 66160


First Created : 1/12/2001
Last Updated : 5/11/2016
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Last Updated : 5/11/2016
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