This document defines pediatric heart failure and reviews its pathophysiology, clinical manifestations, common causes, and treatment. Pediatric heart failure is characterized by insufficient cardiac output to meet metabolic demands, leading to compensatory responses aimed at restoring perfusion. Common causes include excessive preload/afterload, arrhythmias, or decreased contractility. Clinical manifestations vary by age but include feeding difficulties, dyspnea, edema, and hepatomegaly. Treatment focuses on reducing preload and afterload, enhancing contractility and nutrition, and may include ACE inhibitors, beta-blockers, diuretics, or heart transplantation in severe cases.