Background and Aims Sytematic echocardiography in children with ARF in bedside allows the description of cardiac anatomy with the segmental analysis. The aim of this study is to determine the heart malformation as etiology of ARF.

Methods In this prospective study, 53 children with ARF had an echocardiography exploration from september 2009 to march 2012.

Results 53 transthoracic echocardiography (TTE) were performed and congenital heart diseases were found in 29 patients.

Segmental analysis allow morphological and functional study of the heart; search for congenital defects and look for possible hémodynamic causes of ARF like high arterial pulmonary blood pressure.

Conclusion TTE is a non invasive tool useful to bedside of children in PICU for the dignostic of cardiac etiology of ARF. In developing countries systematic TTE must be performed to screening of congenital heart malformations.