Ali SK. Pediatric heart failure: A focus on low-income countries. World J Clin Pediatr 2026; 15(2): 115168 [DOI: 10.5409/wjcp.v15.i2.115168]
Corresponding Author of This Article
Sulafa KM Ali, FRCPCH, FACC, Professor, Clinical Sciences, University of Sharjah, University City Road, Sharjah PO Box 27272, Ash Shāriqah, United Arab Emirates. sulafa.ali@sharjah.ac.ae
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Jun 9, 2026; 15(2): 115168 Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.115168
Pediatric heart failure: A focus on low-income countries
Sulafa KM Ali
Sulafa KM Ali, Clinical Sciences, University of Sharjah, Sharjah PO Box 27272, Ash Shāriqah, United Arab Emirates
Author contributions: Ali SKM contributed to the conceptualization, writing, revising, and finalization of the manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Sulafa KM Ali, FRCPCH, FACC, Professor, Clinical Sciences, University of Sharjah, University City Road, Sharjah PO Box 27272, Ash Shāriqah, United Arab Emirates. sulafa.ali@sharjah.ac.ae
Received: October 9, 2025 Revised: January 4, 2026 Accepted: February 4, 2026 Published online: June 9, 2026 Processing time: 215 Days and 23.7 Hours
Abstract
Heart failure (HF) in the pediatric population is unique because it involves heterogeneous groups of diseases, including congenital and acquired conditions. The etiology of HF varies with age and sociodemographic origin. In low-income countries, unoperated congenital heart diseases are common, leading to a high prevalence of infants with HF and older children with Eisenmenger syndrome. In addition, rheumatic heart diseases are prevalent, leading to advanced HF in children. Infectious diseases such as tuberculosis and schistosomiasis add to the burden of heart diseases through complications, including pericarditis and pulmonary hypertension. In tropical regions, cardiomyopathies (e.g., endomyocardial fibrosis) have unique causes that have been linked to tropical parasitic infections. The management of pediatric HF is constrained by challenges such as late diagnosis and poor access to medical and interventional therapies. Point-of-care ultrasound holds promise for improving early diagnosis, but appropriate training is required for its use. This study reviews the diagnosis and management of HF, with an emphasis on the limitations encountered in low-resource settings.
Core Tip: Heart failure in children has variable congenital and acquired etiologies depending on the age and sociodemographic origin. In limited resource settings, heart failure is mostly due to unrepaired congenital heart disease, rheumatic heart disease and unique cardiomyopathies. Management in such settings is complicated by late presentation and limited access to medical and interventional therapies.
