Pediatric Acute Heart Failure Is Undertreated in the ED

Researchers retrospectively evaluated presentation, treatment, and outcomes in 57 patients younger than 21 who received diagnoses of acute heart failure at a tertiary care pediatric hospital emergency department in Texas from 2003 to 2006. Common presenting signs included hepatomegaly (65%), tachypnea (63%), and tachycardia (54%); less-common presenting signs included peripheral edema (21%), rales (18%), and jugular venous distortion (5%). Common symptoms included dyspnea (74%), nausea or vomiting (60%), and fatigue (56%). Overall, 89% of patients presented with at least one gastrointestinal sign or symptom, and 86% presented with at least one respiratory sign or symptom.

Chest x-ray demonstrated abnormalities in 50 of 52 patients (96%), usu…