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Cognitive and psycholologic considerations in pediatric heart failure
Seth A Hollander1, Edward Callus2
1Department of Pediatrics (Cardiology), Stanford University Medical Center, Stanford, California.
Journal of Cardiac Failure
|July 20, 2014
Summary
Children with heart failure face risks to cognitive and psychosocial health. Early interventions and specialist support are crucial for managing developmental and emotional challenges in these young patients.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Child Psychology
Background:
- Children with heart failure (HF) require long-term care, increasing focus on their cognitive and psychosocial well-being.
- Chronic HF in children is associated with potential delays in cognitive development and psychologic functioning, with unclear long-term impacts.
- Medically managed pediatric HF patients exhibit elevated risks for anxiety and depression, comparable to other congenital heart disease populations.
Purpose of the Study:
- To review the impact of heart failure and its treatments on the intellectual and psychosocial health of children.
- To highlight the risks and benefits of ventricular assist devices (VADs) on neurodevelopment and emotional well-being.
- To identify emerging concerns for children with permanent VADs and recommend management strategies.
Main Methods:
- Literature review focusing on cognitive development, psychologic functioning, and psychosocial health in pediatric heart failure.
- Analysis of outcomes related to medical management, ventricular assist devices (VADs) as bridge-to-transplantation, and permanent VADs.
- Synthesis of evidence regarding risks (e.g., ischemic injury) and benefits (e.g., cognitive stimulation) of VADs.
Main Results:
- Children with HF are at risk for cognitive and psychologic developmental delays.
- VADs present a dual risk/benefit profile for neurocognitive and emotional function, including potential ischemic injury versus improved stimulation and social interaction.
- Children with permanent VADs represent a potentially vulnerable group requiring further study regarding cognitive and social function.
Conclusions:
- Early intervention and school accommodations are recommended for children experiencing cognitive, social, or emotional deficits related to heart failure.
- Brain imaging may be beneficial for persistent neurodevelopmental difficulties.
- Referral to specialized psychologists and developmental specialists experienced with pediatric heart failure is advised.
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