SEMARANG – Heart failure in children often goes unrecognized in its early stages because the symptoms frequently resemble common respiratory problems or growth and developmental disorders. The condition can become dangerous if it is not detected and treated promptly by healthcare professionals.
Through the educational podcast “Oksigen: Obrolan Edukasi Berbagai Elemen,” the Faculty of Medicine Universitas Diponegoro discussed the importance of early detection, rapid treatment, and family support for children with congenital heart disease and heart failure. The podcast was hosted by dr. Nidia and featured two speakers, dr. dr. Anindita Soetadji, Sp.A(K) and dr. Mulyono, Sp.A(K), both lecturers in the Pediatric Specialist Medical Education Program at FK Undip.
According to dr. Anindita, heart failure in children occurs when the heart is unable to meet the body’s metabolic needs optimally. Unlike adults, symptoms of heart failure in children do not always appear as chest pain or other typical cardiac complaints.
“In children, heart failure is not only characterized by shortness of breath, but can also present as failure to thrive, difficulty breastfeeding, and body weight that does not increase according to the growth curve,” she explained.
She added that congenital heart disease is one of the leading causes of heart failure in children. The condition affects approximately 1 percent of live births, or around 10 cases per 1,000 births.
Meanwhile, dr. Mulyono explained that pediatric heart failure cases are frequently encountered in emergency units, particularly among patients who had previously not been diagnosed with congenital heart abnormalities.
“Sometimes children come in only with complaints of shortness of breath. After further examinations, it is discovered that they actually have a heart defect,” he said.
During the podcast, both speakers emphasized the importance of thorough clinical examinations by healthcare workers, especially in primary healthcare services. Procedures such as medical history assessment, heart auscultation, chest X-rays, electrocardiography (ECG), and pulse oximetry screening are considered highly effective for early detection of congenital heart disease.
Anindita explained that screening for Critical Congenital Heart Disease (CCHD) using pulse oximetry is now available for newborns. The examination is conducted by measuring oxygen saturation levels in the baby’s hands and feet.
“If the oxygen saturation is below 95 percent or there is a difference of more than 3 percent between the hands and feet, further examination is necessary,” she said.
However, she also warned that non-cyanotic congenital heart disease, often referred to as “non-blue” heart disease, is frequently difficult to detect at birth. Symptoms may only appear several months later, such as excessive sweating during breastfeeding, interrupted feeding, easy fatigue, and delayed growth.
Healthcare professionals are also advised to remain alert to certain physical abnormalities or dysmorphic features that may be associated with genetic disorders and congenital heart disease.
In managing pediatric heart failure patients, dr. Mulyono emphasized the importance of early stabilization, particularly in emergency situations. Treatment may include oxygen therapy, fluid management, administration of diuretic medications, and mechanical ventilation for patients experiencing pulmonary edema and severe respiratory distress.
“The principle is to manage preload, afterload, and support the heart’s pumping function according to each patient’s condition,” he explained.
Both speakers also highlighted the importance of collaboration among healthcare professionals, ranging from general practitioners and pediatricians to pediatric cardiologists and cardiac surgeons, in determining the best treatment approach for patients.
In addition to medical treatment, emotional support for patients’ families was also considered essential. Parents need to receive education regarding their child’s condition, possible therapies, and the importance of immunization for children with congenital heart disease.
“Children with congenital heart disease are actually more vulnerable to infections, so immunization remains important with proper precautions,” stressed dr. Anindita.
At the end of the podcast, both speakers reminded healthcare professionals to increase awareness of the signs of heart failure in children and not hesitate to refer patients when congenital heart disease is suspected.
“First, recognize the emergency condition, stabilize the patient, and collaborate so that diagnosis and treatment can be carried out as quickly as possible,” said dr. Mulyono.
