<![CDATA[Heart failure in children is a serious clinical syndrome caused by congenital heart disease (CHD) and acquired heart disease (AHD). Differences in clinical profiles and cardiac parameters between these two etiologies are important for accurate diagnosis and appropriate management. The primary objective of this study was to compare the clinical characteristics and cardiac parameters in children with heart failure due to congenital heart disease (CHD) and acquired heart disease (AHD). An analytic observational retrospective cross-sectional study was conducted using medical records of 26 children with heart failure (13 CHD and 13 AHD) at H. Adam Malik General Hospital, Medan, from January to May 2026. Variables included age, sex, nutritional status, Ross classification, dominant symptoms, as well as left ventricular ejection fraction (LVEF), fractional shortening (FS), tricuspid annular plane systolic excursion (TAPSE), troponin, valvular involvement, left atrial enlargement, QRS duration, and QTc interval. Descriptive and bivariate analyses were performed according to data distribution. There were no significant differences in age, sex, and nutritional status between groups, with most patients being undernourished. The predominant symptom was dyspnea/tachypnea, and Ross classification did not differ significantly, although AHD more often presented in higher Ross classes. Median LVEF (63.1 vs 59, p=0.005) and FS (35 vs 30, p=0.007) were significantly higher in the CHD group, whereas QTc interval prolongation was more common in AHD. TAPSE, troponin, QRS duration, valvular involvement, and left atrial enlargement did not differ significantly between groups. Clinical manifestations of pediatric heart failure due to CHD and AHD are similar and insufficient to distinguish etiology, but AHD tends to be associated with more severe left ventricular systolic dysfunction.]]>
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