Heart failure, a common event in childhood with significant morbidity and mortality, has an impact on both children and adults. In adult medicine, heart failure is largely related to coronary insufficiency acquired over years. In children, the blood supply to the heart is rarely compromised, and the nutrient and oxygen supplies are good. The etiologies of heart failure in childhood are thus strikingly different from those for adults and can result from congenital structural defects, inherited cardiomyopathies, acquired disease (e.g., infection or exposure to cardiotoxic agents), or ischemia-reperfusion injury during open heart surgery performed to repair structural defects (Fig. 1).
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