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Congestive heart failure

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What is congestive heart failure?

Congestive heart failure (CHF) occurs when the heart is unable to pump blood effectively. This causes blood and fluid to back up into the lungs, liver, and other organs, making the heart work harder to pump blood around the body.

Congestive heart failure is not the same as a heart attack.

What causes CHF?

In children, the most common cause of CHF is a congenital (present at birth) heart defect. This may be a hole in the wall between the heart chambers or an extra blood vessel. Not all congenital heart defects lead to congestive heart failure. Other conditions can also cause the heart to function poorly and then lead to CHF.

What are the signs of CHF?

The signs of CHF may develop slowly, and parents are often the first to notice changes in their child. These signs do not always mean that your child has CHF, but you should call the clinic if any develop. Signs of CHF are:

  • faster breathing
  • nasal flaring (nostrils open wider with breaths)
  • retractions (pulling in of the skin between or below the ribs with breaths)
  • grunting during rest
  • chronic cough
  • child is more fussy lying down and would rather sit upright
  • urinating less often
  • sweaty or clammy feeling on forehead, face, or body (mostly during feedings)
  • taking longer to eat or to finish a bottle
  • taking smaller feedings more often
  • poor weight gain
  • sleeping more or needing to be awakened for feedings
  • pale or dusky color on skin or lips
  • hands and feet always feel cold
  • swelling of the hands, feet, or eyelids

When should I call the doctor?

Call the cardiology clinic right away if any new signs of CHF are present.

How is CHF treated?

CHF is managed with medicine or surgery. Medicines used to control the symptoms of CHF may include:

  • diuretics, such as Lasix®, are used to remove excess fluid by increasing urination
  • medicines, such as carvedilol, are used to help the heart pump more effectively.
  • medicines, such as enalapril are used to reduce blood pressure and the work load on the heart

If the cause of CHF does not repair itself, it may be necessary to correct the problem with surgery.


This sheet is not specific to your child but provides general information. If you have any questions, please call the clinic.

Reviewed 1/2018

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit

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