The Profile of an Adult with Congenital Heart Disease

Abstract

Congenital heart disease is the most frequent malformation. In the most recent data has a prevalence of thirteen cases per 1,000 children and six cases per 1,000 adults. Great strides in pediatric cardiovascular surgery have increased the number of survivors, especially in adulthood. Nowadays more adults are living with congenital heart disease than children, particularly in developed countries, and more than two thirds fall into the categories of moderate and high complexity defects. This growing population called: Grown up congenital heart, requires super-specialized healthcare, the profile of the new cardiovascular patient differs from the traditional adult with heart disease, the first paradigm that should be broken is to understand that cardiovascular surgery is restorative (it substantially improves the hemodynamic condition), but is not 100% curative. Surgical and survival successes have turned the pediatric patient with congenital heart disease into an adult postoperative patient with residua, sequela and complications. The adult's postoperative heart is not a natural heart, it is a transformed, "neo-formed", heart. They will have relapses and hospitalizations due decompensation to congenital heart disease. A new specialist profile is necessary. Training in adult congenital heart disease is valid beginning from both a pediatric and an adult cardiology environment. The special needs of this population are very costly for health systems. Recognize what are the main causes of decompensation is mandatory and finally adequate care decreases prolonged hospital stays and health system cost.

Complex adult congenital heart disease on cross-sectional imaging: an introductory overview

“…Firstly, approximately 10% of ACHD patients may present with unrepaired disease that may have remained undiagnosed or has been previously diagnosed in childhood. The vast majority of these patients have simple ACHD conditions such as septal defects [5].…”

“…The majority of these patients have complex ACHD, and the numbers are increasing as technological and surgical advances afford better survival rates. These patients have significantly altered haemodynamics and a neo-formed cardiovascular circulation due to the complex interventions performed [5]. Their clinical presentation may be due to an indirect consequence of their altered physiology or a disease-specific post-operative complication presenting in adulthood.…”

“…Their clinical presentation may be due to an indirect consequence of their altered physiology or a disease-specific post-operative complication presenting in adulthood. Common symptoms and clinical findings include chest pain, shortness of breath, arrhythmias and exercise intolerance [5]. As the number of repaired complex ACHD patients continues to rise, it is exceedingly important to obtain as much clinically relevant past surgical history in order to accurately interpret images.…”

Late diagnosis of Ebstein anomaly after pregnancy: A rare case report

“…There is a risk of malformation during fetal development, and congenital heart disease (CHD) is the most common form (Jairo, 2018). From all prevalence of CHD, Ebstein anomaly (EA) is one of the rarest cases (Abramian et al, 2011).…”