A defining characteristic of pediatric heart failure is that the heart cannot meet metabolic demands at which venous pressure?

• A. Normal physiologic venous pressures
• B. Elevated venous pressures
• C. Low venous pressures
• D. Unchanged venous pressures

Answer: (A)

A key idea is that pediatric heart failure is defined by the heart’s inability to supply enough forward flow to meet the body’s metabolic needs, even when venous return and filling pressures are still within the normal range. In children, tissues may become underperfused and symptoms appear before venous congestion develops, so venous pressures stay at normal physiologic levels. Elevated venous pressures indicate congestion and fluid overload, which is not the defining feature early on in pediatric heart failure.