[Heart failure in childhood].

Heart failure (HF) in pediatric patients shows many differences from adult HF because of biochemical and ultrastructural peculiarity due to contractility modifications for different loading conditions, often resulting from congenital heart diseases. The majority of heart diseases in pediatric patients with symptoms and signs of HF are due to severe heart diseases (such as ventricular septal defect, severe aortic stenosis, aortic coarctation syndrome). There are several reasons for early HF in the natural evolution of congenital and acquired heart diseases. They are of hemodynamic nature (pressure and volume overloading, reduced ventricular compliance), or due to systolic ventricular dysfunction. In order to optimize the medical and/or surgical treatment in these conditions an immediate etiological and pathophysiological evaluation should be done. In this regard the echocardiographic technique allows to reach a rapid and accurate diagnosis and a good therapeutic view in a non-invasive and easily to repeat way.