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Pediatric heart failure: A focus on low-income countries
1Clinical Sciences, University of Sharjah, Sharjah PO Box 27272, Ash Shāriqah, United Arab Emirates. sulafa.ali@sharjah.ac.ae.
Insights
Pediatric heart failure (HF) presents unique challenges in low-resource settings due to diverse causes like congenital heart disease and infections. Early diagnosis and access to therapies are limited, hindering effective management.
Area of Science:
- Pediatric Cardiology
- Global Health
- Cardiovascular Diseases
Background:
- Pediatric heart failure (HF) encompasses diverse congenital and acquired conditions.
- Etiology of pediatric HF varies significantly with age and socioeconomic factors.
- Low-resource settings face unique challenges, including unoperated congenital heart disease, rheumatic heart disease, and infectious etiologies like tuberculosis and schistosomiasis.
Purpose of the Study:
- To review the diagnosis and management of pediatric heart failure.
- To highlight the specific limitations and challenges encountered in low-resource settings.
- To explore potential solutions like point-of-care ultrasound for improving early diagnosis.
Main Methods:
- Literature review focusing on pediatric heart failure.
- Analysis of etiological factors across different age groups and geographic regions.
- Examination of diagnostic and therapeutic constraints in resource-limited environments.
Main Results:
- Common causes of pediatric HF in low-income countries include unoperated congenital heart disease, rheumatic heart disease, and infectious diseases.
- Tropical regions present unique cardiomyopathies, such as endomyocardial fibrosis, linked to parasitic infections.
- Late diagnosis and limited access to medical and interventional therapies are major management barriers.
Conclusions:
- Effective management of pediatric heart failure in low-resource settings requires addressing diagnostic delays and accessibility issues.
- Point-of-care ultrasound offers potential for improved early diagnosis, contingent on adequate training.
- Tailored strategies are essential to overcome the unique burdens of pediatric heart failure globally.
Abstract:
Heart failure (HF) in the pediatric population is unique because it involves heterogeneous groups of diseases, including congenital and acquired conditions. The etiology of HF varies with age and sociodemographic origin. In low-income countries, unoperated congenital heart diseases are common, leading to a high prevalence of infants with HF and older children with Eisenmenger syndrome. In addition, rheumatic heart diseases are prevalent, leading to advanced HF in children. Infectious diseases such as tuberculosis and schistosomiasis add to the burden of heart diseases through complications, including pericarditis and pulmonary hypertension. In tropical regions, cardiomyopathies (e.g., endomyocardial fibrosis) have unique causes that have been linked to tropical parasitic infections. The management of pediatric HF is constrained by challenges such as late diagnosis and poor access to medical and interventional therapies. Point-of-care ultrasound holds promise for improving early diagnosis, but appropriate training is required for its use. This study reviews the diagnosis and management of HF, with an emphasis on the limitations encountered in low-resource settings.
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