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.
Hypoxic hypoxia has been shown to cause anorexia
in experimental rats, along with a
concomitant decrease in body weight.9 Chronic
hypoxia may contribute to the feeding problem
in cardiac patients. Malabsorption is also
thought to play a role in cardiac cachexia.4 It
can result from both congestive heart failure
and oxygen lack. We did not investigate occurrence
of malabsorption in our patients. Children
with CHD are known to be in a
hypermetabolic state.10 Heart disease causes an
increase in cardiac and respiratory work.
Decreased intake caused by anorexia combined
with increased respiratory eVort results
in a greater nutrient deficit. Children with
heart disease may need as much as 50% more
calories than normal children in order to
achieve normal growth.1 A combination of
these factors predisposes the infant to malnutrition
and growth failure