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Congenital Heart Disease in Adults

Kristin Laraja, MD and Emily P. Greenstein, MD Reviewed 06/2021
 


BASICS

EPIDEMIOLOGY

Incidence

  • 1% of births each year in the United States (1)

  • ~40,000 live births each year (1:4 severe) (2)

  • Most common cyanotic: tetralogy of Fallot

  • Most common: bicuspid aortic valve (...

DIAGNOSIS

CHD first identified in adulthood 

HISTORY

  • Usually diagnosed prior to adulthood

  • Historical findings: fatigue, dizziness, near-syncope, headaches, cyanosis, exercise intolerance with dyspnea

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Refer to ACHD physician and ACHD regional center for cardiac management (1,2,3,4,5)[C].

  • Contact ACHD center or physician if patient is admitted for reasons non–cardiac relate...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • 12 to 24 months if moderate to severe (2,5)[C]

  • ACHD center with multidisciplinary team including interventional and noninterventional cardiology, EP, cardiac surg...

REFERENCES

1
Webb  G, Williams  R. 32nd Bethesda conference: “care of the adult with congenital heart disease.” J Am Coll Cardiol.  2001;37(5):1162–11...

CODES

ICD10

  • Q24.9 Congenital malformation of heart, unspecified

  • Q24.8 Other specified congenital malformations of heart

  • Q21.3 Tetralogy of Fallot

  • Q23.1 Congenital insufficiency of aortic valve

  • Q21.0 Ventri...

CLINICAL PEARLS

  • Prompt referral and consult to ACHD facility if cardiac admission and/or surgery is warranted.

  • Monitor for ES and severe PAH.

  • 2D/3D Doppler TTE is the first-line imaging modality in all ...

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