Congenital Heart Diseases (Adult Presentation)

Congenital Heart Diseases in Adults

Congenital heart diseases (CHDs) are structural abnormalities of the heart that develop before birth. Thanks to advances in medical care, many individuals with CHDs now survive into adulthood. However, adult patients require lifelong follow-up due to potential complications such as arrhythmias, heart failure, and pulmonary hypertension.

Classification of Congenital Heart Diseases

CHDs can be categorized into:

Acyanotic Heart Diseases (e.g., atrial septal defect, ventricular septal defect, patent ductus arteriosus, and coarctation of the aorta)

Cyanotic Heart Diseases (e.g., Tetralogy of Fallot, transposition of the great arteries, and Eisenmenger syndrome)

Clinical Manifestations in Adults

Although some congenital defects are diagnosed in infancy, others might go undetected until adulthood. Symptoms depend on the type and severity of the defect and may include:

Shortness of breath, especially during exertion

Fatigue

Palpitations or arrhythmias

Cyanosis (bluish skin due to low oxygen levels)

Heart murmur detected on examination

Diagnosis

Evaluation of an adult with suspected CHD includes:

Echocardiography:

Transthoracic or transesophageal

Electrocardiography (ECG):

To check for arrhythmias

Cardiac MRI or CT scan:

For a detailed structural assessment

Cardiac catheterization:

In complex cases to evaluate pressures and oxygen levels

Management varies based on the defect and includes:

Medical Therapy:

Diuretics, beta-blockers, anticoagulants, and heart failure medications as needed:

Catheter-Based Interventions:

Closure of defects like atrial septal defect (ASD) or patent ductus arteriosus (PDA) using occluder devices

Surgical Correction:

Some conditions require specialized surgical repair or even heart transplantation

Lifelong Follow-Up

Adults with CHD require routine follow-ups with specialized cardiologists. Preventive measures include:

Regular cardiac evaluations

Monitoring for arrhythmias or heart failure

Lifestyle modifications (e.g., exercise, avoidance of smoking, balanced diet)

Conclusion

Congenital heart diseases in adults are an important clinical entity requiring multidisciplinary management. With appropriate surveillance and treatment, many patients can maintain a good quality of life.

Information resources recommended

1. Congenital heart diseases in adults are an important clinical entity requiring multidisciplinary management. With appropriate surveillance and treatment, many patients can maintain a good quality of life.

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000603

https://pubmed.ncbi.nlm.nih.gov/30121239/

https://www.jacc.org/doi/10.1016/j.jacc.2021.09.010

https://pubmed.ncbi.nlm.nih.gov/34736567/

https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2018/08/13/16/26/2018-AHA-ACC-Guideline-for-the-Management-of-ACHD

2. 2021 European Society of Cardiology Guidelines for the Management of Grown-Up Congenital Heart Disease

https://academic.oup.com/eurheartj/article/42/6/563/5898606

https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Grown-Up-Congenital-Heart-Disease-Management-of

https://pubmed.ncbi.nlm.nih.gov/32860028/

https://www.jacc.org/doi/10.1016/j.jacc.2021.09.010

https://pubmed.ncbi.nlm.nih.gov/34736567/

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