If, in general, pulmonary hypertension or other cardiac conditions are stable, the child is not on any treatment and there are no other complications at the time and the child has wasting only, then standard antibiotics and thereapetutic feeds should not be a problem. However, it is likely that the wasting is likely partially due to the cardiac condition so the care plan should include early cardiac review.

If the condition is not stable, or there is oedema or hypoxia, the child needs an urgent expert opinion as  this will depend very much on details of the condition and the facilities and expertise available at your centre. I think the forum is not the right place for discussion of an individual patient's care for a complex condition.

I am happy for

Have you thought about a low dose of Sednafil along Side the nutritional care?

This can improve the quality of life 

Thank you for the response @ Jay Berkley

Even in the absence of a specialist, it will be necessary to think about the management of this cardiac pathology and to evaluate its part in the overall situation.

Very useful question: How to diagnose pulmonary hypertensia?

Where is the key?

Check the kind of edema.

Thank you @ Brian Nambale for your response..Yes child is on low dose sednafil. My main concern was on the therapeutic feeds because of the electrolytes and pulmonary edema.

Thank you@ Dieudonne Bikorimana for your response.

For us we diagnose pulmonary hypertension using ECHO ( Echocardiogram) and also checking the Pulmonary artery pressures.

Intersante pregunta. Esta situación, la vivimos frecuentemente en La Guajira colombiana, donde, en muchos de nuestros pacientes coincide la cardiopatía (o cualquier otra causa de desnutrición secundaria) con inseguridad alimentaria grave, siendo excluidos de los beneficios de la alimentación terapéutica.

De acuerdo con la necesidad del estudio exhaustivo y el concurso del cardiólogo pediatra, pero, también considero inhumano, en el contexto de inseguridad alimentaria severa, negar esta opción.

Corduial saludo.

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This response has been automatically translated

Interesting question. We often experience this situation in La Guajira in Colombia, where many of our patients have heart disease (or any other cause of secondary malnutrition) and severe food insecurity, and are excluded from the benefits of therapeutic feeding.

I agree with the need for an exhaustive study and the assistance of the paediatric cardiologist, but I also consider it inhumane, in the context of severe food insecurity, to deny this option.

Best regards.

Thank you@ Spencer Rivadeneira Danies for your reply.

Kind Regards