Story by: Kim Huston on August 20, 2021
Heart failure is a condition that can affect people of all ages. In heart failure, the heart doesn’t pump as efficiently as it should. What causes heart failure in children?
In heart failure, the heart hasn’t stopped working; it’s just not working as well as it should. The heart is unable to pump blood well enough to meet the body’s needs. Heart failure often signals an underlying, progressive heart condition.
Heart failure typically occurs due to two types of conditions: a complex congenital heart defect or cardiomyopathy, a change in the heart muscle itself.
Children born with a complex congenital heart defect who required a surgical repair or palliation early in life sometimes can develop issues with the way the heart pumps. Sometimes this is caused by ongoing issues with the structural components of the heart, such as the heart valves, but sometimes the heart pump simply wears out over time.
Cardiomyopathy is an issue with the heart pump in a child who has a structurally normal heart. It is an issue with the heart muscle itself. This can be caused by a change in genetics that is typically inherited and, over time, children can develop issues with the way the heart pumps. There are some patients with certain conditions, like muscular dystrophy, who are more at risk for developing a cardiomyopathy with pump failure.
Cardiomyopathy also can be caused by something acquired throughout life. The most common cause of this is myocarditis, inflammation of the heart muscle due to a viral infection. Other reasons include issues with the coronary arteries caused by inflammation, or structural issues with the blood vessel itself that carries blood flow to the heart muscle. Abnormal heart rhythms, if untreated, sometimes can cause pump failure. Some medications, especially some chemotherapy agents used to treat cancer, sometimes can cause pump failure over time. And even conditions not related to the heart sometimes can lead to pump failure: chronic lung disease, chronic kidney disease, other inflammatory conditions or infections.
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Heart failure is usually diagnosed with tests such as an echocardiogram, which is an ultrasound of the heart, as well as additional imaging and laboratory data. Heart failure requires special care by a pediatric cardiologist experienced in the care of children with heart failure. This care will depend on many factors, including the extent of the disease and the symptoms of the patient. Treatments can include things such as medications, surgical procedures — such as the implantation of a ventricular assist device (VAD) — or even heart transplantation.
A VAD is a surgically implanted device that helps the heart pump when a child continues to have severe heart failure despite maximum medical therapy. Typically, this is used a bridge to heart transplantation, but also can be used as a bridge to heart recovery. Pediatric VADs can be implanted in ages ranging from infants to teenagers. Some teens are able to leave the hospital and live at home with a VAD. Such a device requires advanced care by specially trained heart failure pediatric cardiologists, pediatric cardiothoracic surgeons, pediatric cardiac intensivists and VAD nurses. Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, implants VADs in children of all ages with severe heart failure due to both congenital heart disease and cardiomyopathy.
Norton Children’s Heart Institute is Kentucky’s and Southern Indiana’s only complete resource for children with cardiomyopathy, heart failure and conditions requiring a heart transplant. Our cardiologists are board certified and fellowship trained to care for your child. Our physicians also are faculty at the University of Louisville School of Medicine — they are at the forefront of new treatments, training the next generation of heart failure specialists. The experience and expertise of Norton Children’s Heart Institute physicians make them leaders in positive outcomes for children with cardiomyopathy and heart failure.