Challenges in medication titration in children with heart failure.

The management of pediatric heart failure and titration of oral medical therapies remains in its infancy. Burdened by a lack of understanding of the diverse pediatric heart failure etiologies, limitations in clinical trials, a lack of society guidelines, as well as other health care systemic issues, titration of medications is greatly lacking. We herein review the difficulties with medication titration in pediatric heart failure, and highlight important next steps to remedy the situation.