GuidelinesPrimary Care STG
Cardiac Failure, Congestive (CCF), Children
Cardiac Failure, Congestive (CCF)
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: dosing tables
- Do not put up a drip or run in any IV fluids
REFERRAL
- All children with suspected congestive cardiac failure
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_1 November 2024
Chapter 4: Cardiovascular Conditions_4.6.2 Cardiac Failure, Congestive (CCF), Children