Suspected Acute Heart Failure — Child with Suspected Heart Failure — Clinical Pathway: Emergency, ICU and Inpatient

Suspected Acute Heart Failure Clinical Pathway — Emergency Department, ICU and Inpatient

Child with Suspected Heart Failure

Heart failure (HF) is a complex clinical syndrome with multiple etiologies and diverse clinical manifestations. Acute decompensated HF is defined as cardiac dysfunction resulting in inadequate peripheral oxygen delivery at rest or during stress. HF can be either new onset, or result from decompensation of chronic HF with symptoms that warrant hospitalization. Dysfunction may manifest as primarily systolic, diastolic, or mixed. Clinical symptoms and signs can vary substantially during the course of the disease process and may not correlate with changes in underlying cardiac function.

Patients with acute decompensated HF may deteriorate rapidly with medical interventions such as endotracheal intubation and IV fluid administration and therefore the symptoms of acute HF must be recognized early in the course of a patient’s presentation.
History and Physical Examination

Use this pathway for children with suspected acute heart failure.

Eligibility Criteria
  • Birth to 18 years
  • Chronic HF with acute decompensation
  • New onset heart failure
  • Cardiogenic shock
Exclusion Criteria
  • Adults (> 18 years)
  • Neonates with corrected postnatal age < 35 weeks
  • Infants receiving prostaglandins or a potential need for prostaglandin infusion

Patients at HIGH RISK for acute decompensated heart failure include, but are not limited to patients with:

History of:

  • Prior heart failure
  • Cardiomyopathy
  • Heart transplantation
  • Metabolic/mitochondrial disease
  • Neuromuscular disease (e.g. Duchenne muscular dystrophy)

Family history of:

  • Heart failure
  • Cardiomyopathy
  • Heart Transplantation