For each, the natural history and common clinical presentations resulting from the shunt are discussed. In this first portion, simple shunt lesions are reviewed. This 3-part series focuses on the pathophysiology of congenital heart lesions, which are seen commonly in adult patients. As these patients increasingly present to cardiologists’ offices for care, healthcare professionals will need to develop a better level of comfort with adult congenital heart disease. 5 This specialized cardiac care will require the diagnosis of adult congenital heart disease in patients presenting de novo with new or chronic symptoms, the long-term maintenance of those previously diagnosed, and the ability to recognize when primary or additional interventions are required. While the adult cardiology community struggles with a population that once was the exclusive domain of pediatricians, governmental agencies, national physician associations, and cardiology advisory boards are trying to define the scope of this national healthcare issue and to figure out how to train current and future generations of doctors. It is estimated that >1 million adults in the United States now have congenital heart disease, outnumbering their pediatric counterparts for the first time. The adult congenital heart disease patients carry a spectrum of disease, from small septal defects and minor valvar obstructions to complex single-ventricle lesions that have been palliated with staged surgical repairs. 2 In addition, using improved noninvasive techniques, adult cardiologists are increasingly identifying adults with septal defects that were undiagnosed in childhood.
1 With the successes in cardiothoracic surgery over the past 3 decades and the ongoing improvements in the diagnostic, interventional, and critical care skills of pediatric cardiologists, ≈90% of children born with heart defects now survive to adulthood. Customer Service and Ordering InformationĬongenital heart disease is common, occurring in ≈8 of 1000 live births.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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