I50.0/I50.1-9
DESCRIPTION
The congestion of the systemic or pulmonary venous systems due to cardiac dysfunction of various different causes; including congenital heart disease and acquired cardiac and lung conditions (e.g. cor-pulmonale due to bronchiectasis in HIV-infected children).
Often mistaken for respiratory infection.
Signs and symptoms
Infants
- rapid breathing
- chest indrawing
- rapid heart rate
- crackles or wheezing in lungs
- cardiomegaly
- active cardiac impulse
- enlarged tender liver
Often presents primarily with shortness of breath, difficulty in feeding and sweating during feeds. Oedema is usually not an obvious feature.
Children
- rapid breathing
- chest indrawing
- rapid heart rate
- crackles or wheezing in lungs
- cardiomegaly
- active and displaced cardiac impulse
- enlarged tender liver
- oedema of the lower limbs or lower back
GENERAL MEASURES
While arranging transfer:
- Oxygen, using nasal cannula at 2–3 L per minute.
OR
- Oxygen 40%, using face mask at 2–3 L per minute.
- Semi-Fowlers position.
Note: If hypertensive, consider glomerulonephritis in children.
MEDICINE TREATMENT
While arranging transfer:
If CCF is strongly suspected
- Furosemide, IV, 1 mg/kg, over 5 minutes. See: Paediatric dosing tool.
- Do not put up a drip or run in any IV fluids.
REFERRAL
All children with suspected congestive cardiac failure.