As in adults, heart failure in infants and children results from
the inability of the heart to maintain the cardiac output required
to sustain metabolic demands.34,35 Congenital heart defects
are the most common cause of CHF during childhood.
Surgical correction of congenital heart defects may cause heart
failure as a result of intraoperative manipulation of the heart
and resection of heart tissue, with subsequent alterations in
pressure, flow, and resistance relations. Usually, the heart failure
that results is acute and resolves after the effects of the surgical
procedure have subsided. Chronic congestive failure occasionally
is observed in children with severe chronic anemia,
inflammatory heart disease, end-stage congenital heart disease,
or cardiomyopathy. Inflammatory heart disorders (e.g., myocarditis,
rheumatic fever, bacterial endocarditis, Kawasaki’s disease),
cardiomyopathy, and congenital heart disorders are discussed
in Chapter 17