Pediatric heart failure: A focus on low-income countries

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.