Junaid Rashid, Muhammad Khalil, Muneeza Natiq, Sumair Anwar, Malik M Nazir Khan.
Etiology of Congestive Heart Failure in children.
Pak Paed J Jan ;27(4):145-51.

Objective: To study the various causes of congestive heart failure (CHF) in children. Study design:- Prospective Descriptive type of study. Time span of 1 `h year. Settings: Paediatric unit Jinnah Hospital Lahore, a post graduate and under graduate teaching hospital. Materials and methods:- Over a period of 18 months all children between the age of 0-15 years presenting with signs and symptoms suggestive of cardiac failure were evaluated and relevant investigations were done for the underlying eitology. Those patients who died or left against medical advice (LAMA) before the cause of cardiac failure could be established were excluded. Fifty nine patients were evaluated of which 9 were excluded. The diagnosis of heart failure was clinical and the cases were studied in three age groups i.e. 0-1 year, 1-5 years, 5-15 years. Results: Out of the total 50 patients, majority 33 (66%) were males and the commonest etiology of CCF was acute viral myocarditis. Eighteen patients (36%) were below one year of age and the commonest etiology was congenital heart disease (CHD) of which 8 pts.-44% had ventricular septal defect on top of the list. Other etiologies included lower respiratory tract infections (LRTI), acute myocarditis and supra ventricular tachycardia (SVT). Nineteen patients (38%) were between 1-5 years and the commonest cause was acute myocarditis (10-pts-53%), other causes included cardiomyopathy (CMP), thalassemia with severe anemia and CHD. Thirteen (26%) cases were between 5-15 years and the commonest cause was rheumatic carditis (7 pts.-54%),other causes included dilated CMP,and chronic renal failure. Overall 16% patients presenting with cardiac failure had non-cardiac causes. Conclusions: It was concluded that cardiac failure could occur at any age, was more common in males and acute myocarditis was the most common etiology. In infancy, congenital heart disease was the predominant etiology but SVT and pneumonia could also cause CCF. In our setup thalassemia presented with cardiac complaints rather early due to severe untreated anemia. Rheumatic carditis was the commonest cause of CCF beyond 5 years.

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