Congestive cardiac failure (CCF), also known as congestive heart failure, is a common pediatric emergency that indicates inadequate cardiac output. It can be caused by congenital heart disease, acute rheumatic fever, rheumatic heart disease, myocarditis, hypertension, cardiomyopathy, chronic pulmonary disease, respiratory infections, anemia, nephrotic syndrome, or ventricular tachycardia. Signs and symptoms include impaired myocardial function, tachycardia, weak pulses, cool extremities, pallor, excessive sweating, activity intolerance, and dyspnea. Diagnosis involves collecting a history, performing a physical exam including heart auscultation, and tests like chest x-rays. Treatment consists