Optimizing treatment for chronic congestive heart failure in children.
Treatment strategies for chronic heart failure in children have generally been extrapolated from studies in adults with heart failure. This presentation reviews the existing knowledge and recommendations regarding the treatment of chronic heart failure in adults and the information that is available in children. Medications currently recommended for use in adults include diuretics, digoxin, angiotensin-converting enzyme inhibitors, and beta-blockers. These recommendations are based on results from large, randomized, multicenter trials. Anecdotal evidence suggests similar beneficial effects of these medications in children. The fact that the etiologies, pathophysiology, and physiologic consequences of heart failure in children often differ greatly from those in adults, however, justifies the development of prospective, randomized trials to evaluate these medications specifically in children. Findings from these types of studies will provide critical information for developing guidelines for the appropriate treatment of children with chronic heart failure.
Shaddy
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University of Utah School of Medicine, and the Heart Transplant Program, Primary Children's Medical Center, Salt Lake City, UT, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy*; D006801:Humans
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D002317:Cardiovascular Agents; D004232:Diuretics; D004077:Digoxin