Pediatricsintermediate
Describe the common clinical presentation of DCM in infants and young children.
Answer
Symptoms may include irritability, anorexia, abdominal pain, cough from pulmonary congestion, and exertional dyspnea. Infants and younger children commonly have respiratory symptoms and failure to thrive. Examination may show tachycardia, cool pale skin, weak pulses, raised jugular venous pressure, hepatomegaly, edema, rales or wheeze, cardiomegaly, a gallop, and sometimes holosystolic mitral or tricuspid regurgitation murmurs.
Explanation
DCM can present as heart failure, but the symptoms vary with age. Young children may appear to have a respiratory illness, with cough, dyspnea, rales, or wheeze; poor feeding and **failure to thrive** may also be prominent. Signs of low output and venous congestion can coexist. **Key takeaway:** In a young child, respiratory symptoms and poor growth may be clues to cardiac failure.\n\n**Glossary:** **Pulmonary congestion**: Increased fluid or pressure in the lung circulation. **Hepatomegaly**: Enlarged liver. **Gallop rhythm**: An additional heart sound associated with abnormal filling or function.
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