Heart Failure and Congenital Heart Disease

Heart failure happens when the heart cannot pump blood effectively enough to meet the body’s metabolic needs. This can happen when the heart muscle becomes weak (systolic heart failure) or too stiff to fill properly (diastolic heart failure). See an animation of heart failure.

When the heart’s pumping ability is reduced, blood and fluid can back up in the body. This may cause fluid to build up in the:

• Lungs (congestion)
• Legs and feet (swelling)
• Abdomen

Because of this fluid buildup, the condition is often called congestive heart failure. 

Older children with congenital heart disease (CHD) and heart failure may experience fatigue. They may have difficulty keeping up with peers during physical activity. 

Infants with CHD and heart failure usually show symptoms during feeding. These include sweating, fast breathing (tachypnea) and fatigue. These infants may also have poor weight gain.  

To help the body remove extra fluid, a moderate low-sodium diet may be recommended. Medication options include:

• Diuretics, or water pills, such as furosemide help reduce fluid overload by increasing urine output.
• Medications that relax blood vessels, such as captopril or enalapril, reduce the workload on the heart and help it pump more effectively.
• Digoxin may sometimes be used to help the heart contract more effectively, though it is less often prescribed today.

Patients should be evaluated by specialists with experience in medical and surgical management of CHD and by advanced heart failure experts to assess possible options for advanced therapies, including heart transplantation.