Congestive heart failure

Congestive heart failure refers to a series of clinical syndromes caused by decreased cardiac pump function, increased systemic and pulmonary venous pressure, and cardiac output that cannot meet the body's metabolic and growth needs. Its etiology is mostly due to myocardial disease, decreased contractility, or structural abnormalities causing excessive cardiac load. It can occur at any age, but is more common in infancy and is a common pediatric emergency. The main clinical manifestations of congestive heart failure in children are: 1. In older children, mainly fatigue, dyspnea on exertion, poor appetite, cough, increased heart rate, rapid and shallow breathing, jugular venous distension, hepatomegaly with tenderness, positive hepatojugular reflux sign; in severe cases, orthopnea, moist rales at the lung bases, oliguria, edema, and cyanosis. 2. In infants, manifestations include rapid, shallow breathing, feeding difficulties, irritability, excessive sweating, weak crying, slow weight gain, tachycardia, or gallop rhythm, moist rales or wheezing in the lungs, and rapid liver enlargement. The disease is mainly diagnosed through chest X-ray, electrocardiogram, echocardiography, blood gas analysis and pH measurement, blood biochemistry, and blood glucose measurement. Chest X-ray shows generalized cardiac enlargement with weakened cardiac pulsation. In addition, neonatal hypoglycemia can lead to heart failure. Myocardial ischemia, renal function, and anemia can also be examined, which helps determine the etiology and guide treatment. For pediatric patients with congestive heart failure, in addition to actively treating the primary disease, measures such as sedation, oxygen administration, inotropic support, diuresis, vasodilation, fluid restriction, and salt restriction should be taken as appropriate. The child should rest in bed; those with dyspnea should be placed in a semi-recumbent position; those who are irritable should be given sedatives as appropriate; those with dyspnea or cyanosis should receive oxygen promptly; and fluid and sodium intake should be restricted as appropriate. Bacterial and viral infections, fatigue, and emotional excitement are the main factors inducing heart failure and should be actively prevented. In some cases, long-term maintenance digoxin should be used to prevent heart failure. Children should pay special attention to preventing colds, oral care should be performed, and patients should be guided to maintain a reasonable daily routine and adjust clothing appropriately. The ward should be kept ventilated. Regarding diet, overeating should be avoided, irritating foods should be avoided, and small frequent meals of easily digestible, nutritious, and vitamin-rich foods should be given.