Adult congenital heart defect
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Congenital heart disease is a type of defect in one or more structures of the heart or blood vessels that occur before birth. The heart structures, or vessels, do not form as they should during pregnancy, while the fetus is developing in the uterus. Congenital heart defects may be diagnosed before birth, right after birth, during childhood or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms of congenital heart disease are present, they may include:.
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In the United States, there are now more people over the age of 20 with congenital heart disease CHD than under that age. Survival to adulthood is better because of improved fetal diagnoses, advances in neonatal intensive care, improved surgical techniques, early complete surgical repair, lower perioperative mortality, and increased midterm and late survival. The most common defects seen in adult patients are atrial septal defects, aortic stenosis, coarctation of the aorta, pulmonary stenosis, Ebstein anomaly, tetralogy of Fallot, and corrected transposition. Other common defects seen in adults are double-outlet right ventricle, postoperative atrioventricular canal, subaortic stenosis, abnormal mitral valve, primum atrial septal defect, and single ventricle.
One million people over the age of 20 suffer from congenital heart disease in the United States. These adult patients can slip through the cracks of our medical system; many are too old to be cared for in most pediatric institutions by pediatric cardiologists and, unfortunately, most adult cardiologists are not trained in congenital heart disease. Therefore, it is important to identify the common lesions in adult congenital heart disease and how they should be managed. Acyanotic congenital heart disease in the adult population primarily involves left-to-right shunts, such as atrial septal defect, patent ductus arteriosus, and obstructive lesions such as aortic coarctation of the aorta. The most common form of cyanotic congenital heart disease in adults is tetralogy of Fallot.