الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Heart failure in children is a complex disease process, which can occur secondary to a variety of aetiologies, including CHD, cardiomyopathy, or acquired conditions as well. Although the overall incidence of disease is low, the associated morbidity and mortality are high. Mortality may have decreased slightly over the last decade, and this is likely due to our ability to shepherd patients through longer periods of significant morbidity, with lasting effects. Heart failure (HF) is a complex clinical syndrome resulting from diverse primary and secondary causes, and shared pathways of disease progression, correlating with substantial mortality, morbidity and cost. HF in children is most commonly attributable to coexistent congenital heart disease (CHD), with different risks depending on the specific type of malformation. Current management and therapy for HF in children are extrapolated from treatment approaches in adults. The International Society for Heart and Lung Transplantation defines pediatric heart failure (HF) as “a clinical and pathophysiologic syndrome that results from ventricular dysfunction, volume, or pressure overload, alone or in combination. In children, it leads to characteristic signs and symptoms, such as poor growth, feeding difficulties, respiratory distress, exercise intolerance, and fatigue, and is associated with circulatory, neurohormonal, and molecular abnormalities.” Congenital heart disease (CHD) is frequently associated with ventricular dysfunction, volume or pressure overload. Heart failure in pediatric patients with congenital heart disease has various causes, some of which overlap with the causes of cardiomyopathy, resulting in both .