Rai Muhammad Asghar, Tabish Haze, Shamim A Qazi, Yasir Bin Nisar.
Cardiac failure with pneumonia in young children (<5 yrs age): an overlooked, often fatal but treatable complication.
Ann Pak Inst Med Sci Jan ;1(2):70-3.

Background: Amongst children with WHO defined severe or very severe pneumonia, cardiac failure may contribute to significant mortality. Cardiac failure in pneumonia may occur due to myocardial damage from circulating toxins or due to pulmonary hypertension. Study Design: Prospective, descriptive study. Place and Period of Work: Department of Pediatric, Rawalpindi General Hospital, Rawalpindi, from December 2001 to March 2002. Objective: To evaluate the importance of cardiac failure with pneumonia in children admitted in the pediatric department of Rawalpindi General Hospital, Rawalpindi during the period of study. Results: A total of 275 children who presented with WHO defined severe and very severe pneumonia were enrolled. Two hundred and twenty eight (83%) children were < 1 year of age. Children >5 years of age and those having evidence of congenital heart disease were excluded. Two hundred and thirty (83.6%) children were diagnosed to have severe pneumonia whereas 45 (16.4%) had very severe pneumonia. Of 275, 110 (40%) patients had cardiac failure. Out of total 275, 33 (12%) children died, of which 22 (66.6%) had cardiac failure. Mortality was significantly associated with very severe pneumonia and cardiac failure. Conclusion: Cardiac failure is a common complication with pneumonia in young children (<5 years, age) and must be looked for as in-time management can reduce the mortality.

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