LAUSR

N ew-onset heart failure (HF) in children and adolescents, in the absence of congenital cardiac disease, is rare, estimated at <1 per 100,000. However, when it occurs, it is devastating, with some reports suggesting that up to one-third of patients either die or require heart transplantation (1). In this issue of the Journal, Carr et al. (2) report the incidence of HF in a Swedish national cohort registry of >2.6 million young people, with and without structural cardiac disease, born between 1987 and 2012. Rates of early HF during this period seem to be similar in Scandinavia as previously reported for other countries, with a typical bimodal age distribution characterized by peaks <5 years and in very early adulthood.