Abstract
Heart failure or reduced cardiac output is defined by the pathophysiologic state where the heart is unable to pump oxygen and blood to meet the body's metabolic demands. Preload, afterload, contractility, and heart rate are determinants of cardiac output. In adults, intrinsic depression in cardiac contractility from, for example, ischemic heart disease leads to congestive heart failure. In pediatrics, heart failure can not only be caused by intrinsic depression of cardiac contractility but can also be caused by structural heart defects, congenital, postsurgical, or acquired. Abnormal loading conditions placed on the heart can lead to heart failure even when contractility remains relatively normal. In this chapter, we will focus on interventions that can treat certain forms of congenital or postsurgical obstructive lesions, volume loading shunts, and other miscellaneous lesions leading to or exacerbating heart failure.
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