Four-year-old children shouting tired all day long may be related to atrial septal defect, pulmonary stenosis, anemia and so on. 1. Atrial septal defect: the heart’s fractional flow is small at birth, and the fractional flow increases with age. Generally, there are no uncomfortable symptoms when the defect is small. When the defect is large, it causes pulmonary congestion and insufficient blood volume in the body circulation. When the defect is large, it causes pulmonary congestion and insufficient blood flow in the body circulation. Symptoms such as fatigue and excessive sweating may occur. 2. Pulmonary stenosis: generally mild stenosis has no obvious symptoms, moderate stenosis with age, can lead to insufficient blood supply to the heart after physical activity, there will be fatigue and shortness of breath performance. 3. Anemia: Iron deficiency anemia may be caused by picky eating or iron absorption disorders. Generally can be manifested in easy fatigue, lips and mucous membrane whitening and other symptoms. There are other reasons why a four-year-old child is often tired, it is recommended to consult a doctor in a timely manner, follow the doctor’s instructions for further examination, with the help of the doctor to clarify the cause, and targeted treatment or treatment.