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Heart Failure

What Is Congestive Heart Failure?

Heart failure (also called congestive heart failure) occurs when the heart is not able to pump enough blood to the other organs in the body. The heart continues to beat, but it pumps a smaller amount of blood. When the blood cannot move forward, it causes a back-up and collects in the lungs, veins and liver.

The effects of heart failure vary, depending on which part of the heart is affected. Heart failure can affect the right side, the left side, or both sides of the heart.

When the right side of the heart is affected, the heart cannot effectively pump blood into the lungs, and a back-up of blood accumulates in the liver and veins. This can cause fluid retention and you may notice swelling in your child’s face, eyelids, legs, ankles or abdomen.

Heart failure that affects the left side of the heart can strain the rest of the body, including the lungs. When the heart cannot pump blood out to the other organs, the blood backs up in the vessels of the lungs, causing lung congestion. Children may experience difficulty breathing and may breathe faster. Because blood is not efficiently reaching the rest of the body, children often become fatigued (tired) and may have a decreased rate of growth.

What Are the Symptoms of Heart Failure?

Children suffering from heart failure may show some of the following signs:

  • Fast breathing
  • Shortness of breath, heavy breathing or labored breathing
  • Fatigue (tiredness)
  • Swelling of the face, eyelids, legs, ankles or abdomen
  • Nausea, vomiting or abdominal pain
  • Falling asleep while eating
  • Decreased appetite
  • Cough and/or lung congestion
  • Excessive sweating
  • Slow growth or poor weight gain

What Are the Causes of Heart Failure?

There are 2 main causes of heart failure in children:

Congenital (present at birth) heart defects

There are several different types of congenital heart defects that cause heart failure. These defects include structural problems that prevent the blood from moving through the heart efficiently. Instead, the blood has to move through alternative pathways, which results in a smaller amount of blood reaching the other organs.

Myocardium (heart muscle) thickening

When the muscle material in the heart thickens, it does not function well. A thick muscle reduces the amount of blood the heart can pump. When this happens, the heart cannot supply the body with enough blood to function properly.

How Is Heart Failure Diagnosed?

If your child is experiencing symptoms of heart failure, or if the physician notices something abnormal during a physical exam, they may recommend additional testing. Sometimes the physician may hear extra sounds, called a heart murmur, when they listen to your child’s heart with a stethoscope.

The following tests may be used:

Electrocardiogram (EKG or ECG)

Electrocardiogram (EKG or ECG) is a painless exam that checks the heart’s electrical activity. The exam can detect damage or irregular heart rhythms that may indicate the right ventricle is not functioning properly.

Chest X-rays

These images are used to look at the heart and lungs. If the right side of the heart is enlarged, it may indicate an atrial septal defect (ASD), which is a hole in the wall between the two upper chambers of the heart.


Sound waves are used to produce images of the heart and vessels on a computer screen. This exam can determine whether or not the heart is pumping properly. It can also identify an atrial septal defect (ASD).

Cardiac Magnetic Resonance Imaging (MRI)

This exam uses radio waves, magnets and a computer to create three-dimensional images of the heart. It can reveal structural abnormalities, like an enlarged right ventricle, that can be caused by an atrial septal defect (ASD).

Cardiac Catheterization

Thin, long tubes are inserted into blood vessels and guided into the heart, with the help of fluoroscopy (X-ray), to look for abnormalities.

How Is Heart Failure Treated?

Treatment for heart failure depends on the severity of the condition. Many children with mild heart failure can be managed with medications and live normal lives. More advanced cases of heart failure may require a hospital stay with IV medications to support the heart.

When a child has severe heart failure, they may require a life-saving procedure. One option is a heart transplant. Another option is a Ventricular Assist Device (VAD), which is a mechanical pump to help the heart pump blood to the rest of the body.

The Children’s Heart Institute at Children’s Memorial Hermann Hospital specializes in all levels of treatment for congestive heart failure, from mild to severe. Our heart-transplant and VAD teams are prepared to care for your child’s long-term needs so they can live a better life.

Why Choose Children’s Memorial Hermann Hospital?

The Children’s Heart Institute at Children’s Memorial Hermann Hospital earned the three-star rating, the highest possible distinction, from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in congenital heart surgery. As one of only 10 three-star programs of the STS’s 118 participating programs, the Children’s Heart Institute ranks among the elite in the United States and Canada for congenital heart surgery.

Children’s Memorial Hermann Hospital is recognized as one of the top 50 best children's hospitals nationally in Cardiology & Heart Surgery by U.S. News & World Report. Children’s Heart Institute, in collaboration with pediatric sub-specialists at McGovern Medical School at UTHealth, provides comprehensive care for newborns and children, with the ability to transition into adult congenital cardiac care.

Contact Us

Pediatric Cardiology Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 370
Houston, TX 77030
Phone: (713) 486-6755 (Appointment Line)

Pediatric and Congenital Heart Surgery Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 370
Houston, TX 77030
Phone: (713) 500-5746

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