The cause of growth retardation in CHD is
multifactorial.1348 Inadequate caloric intake,
malabsorption, and increased energy requirements
caused by increased metabolism may all
contribute. However, inadequate caloric intake
appears to be the most important cause of
growth failure in CHD.1 3 A characteristic
feeding pattern of children with CHD is
defined, with a large variation in caloric intake.1
When heart failure is mild the infant commonly
overfeeds, and fluid and sodium overload
disturb cardiac haemodynamics, leading
to decompensation of heart failure and decreased
intake. As a result, the individual’s
overall nutrient intake is inadequate. Arterial
blood gas analysis of patients with congestive
heart failure commonly reveals normal values,
but a form of “stagnant anoxia” caused by
sluggish capillary blood flow within the tissues,
which leads to cellular hypoxia, occurs in congestive
heart failure.4 Anorexia also accompanies
malnutrition and further compromises the
patient’s condition. Dyspnoea and tachypnoea
in patients with congestive heart failure lead to
propensity for fatigue and decreased intake.
Chronic hypoxia is reported to aVect growth.