Management and Experiences in Diagnosing and Treating Acute Heart Failure in Children with Solid Tumors

Acute heart failure is a critical and life-threatening complication that occurs during the treatment of solid tumors in children. It has a high mortality rate, poses treatment challenges, and also affects the overall prognosis of tumor treatment. Currently, there are limited clinical diagnostic and treatment data in this area. To understand the characteristics and outcomes of acute heart failure in children with solid tumors during the treatment process, share treatment experiences, and provide management strategies for monitoring, treatment, and prevention. Five representative cases of children with solid tumors were selected to summarize the clinical features, auxiliary examination data, individualized treatment plans, and treatment effects during the occurrence of acute heart failure. The possible triggers and time points for the onset of acute heart failure in children with solid tumors were analyzed, along with treatment responses and influencing factors. All five cases of children with solid tumors exhibited symptoms of acute heart failure after chemotherapy, with heart functions staging from class II to class IV. Most cases occurred during the bone marrow suppression period after chemotherapy, with a noticeable increase in heart rate during the early stages of heart failure. Those using anthracycline drugs did not reach the internationally recommended maximum cumulative dose. Two children with heart function class IV altered their tumor treatment plans to completion, and one child with heart function class IV and concurrent renal dysfunction had chemotherapy interrupted. All children received oral anti-heart failure treatment and nutritional myocardial therapy. Two children with heart function class II returned to normal after oral medication; three children with heart function class IV received intravenous vasoactive agents during the acute phase of heart failure, followed by regular reinforcement in the later stage. The heart function improved in all three cases (heart function class IV), with one case returning to normal, one case with slow recovery in non-compaction cardiomyopathy gradually approaching normalcy, and one case with only mild improvement in heart function despite concurrent renal dysfunction. Children with solid tumors are susceptible to acute heart failure during the bone marrow suppression period and an increased heart rate serves as an early warning signal. Active anti-heart failure treatment is effective. For severe cases, regular intravenous administration of vasoactive agents during the maintenance period can promote the recovery of heart function, with renal dysfunction emerging as a significant factor influencing poor recovery of heart function.