Overview
Adult congenital heart disease (ACHD) refers to one or more problems with the heart's structure that a person is born with and continues to experience throughout their life. Congenital heart disease affects the way blood flows through the heart, and there are many different types of congenital heart defects. Some types may be mild, while others can cause life-threatening complications. However, advances in diagnosis and treatment continue to improve survival for those with ACHD. People with ACHD require lifelong medical care, which may include regular checkups, medications, or surgery. It is essential to have regular checkups with a health care provider trained in caring for people with congenital heart disease, such as a pediatric cardiologist or adult congenital cardiologist.
Understanding the disease
Symptoms
Symptoms of adult congenital heart disease may include irregular heart rhythms (arrhythmias), shortness of breath, feeling tired quickly with activity, swelling of body tissue or organs (edema), and blue skin, lips, and fingernails (cyanosis). If you have worrisome symptoms such as chest pain or shortness of breath, seek emergency medical attention. If you have signs or symptoms of congenital heart disease or were treated for a congenital heart defect as a child, make an appointment to see your healthcare provider.
Risk Factors
Risk factors for developing adult congenital heart disease include:
- Genetics: Congenital heart disease appears to run in families, and it's associated with many genetic syndromes. Having a family history of congenital heart disease may increase the risk of developing it.
- German measles (rubella): Having rubella during pregnancy may affect how the baby's heart develops while in the womb.
- Diabetes: Having type 1 or type 2 diabetes during pregnancy may affect a baby's heart development.
- Smoking: Smoking during pregnancy increases the risk of a congenital heart defect in the baby.
- Family history and genetics: Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with an extra 21st chromosome (Down syndrome) have congenital heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. It's important for individuals with congenital heart disease to seek lifelong medical care and follow their healthcare provider's recommendations for checkups and treatment.
Development
Congenital heart disease in adults occurs when there is a problem with the heart's structure present since birth. It can affect various parts of the heart, such as the arteries, valves, chambers, or the septum that separates the chambers. The causes of congenital heart disease are not fully understood, but it's believed that certain environmental and genetic factors may play a role, such as genetic mutations, exposure to certain chemicals or infections, and maternal health conditions during pregnancy. Some types of congenital heart disease may be mild, while others can cause life-threatening complications. Adults with congenital heart disease require lifelong medical care, which may include regular checkups, medications, or surgery, depending on the severity of the condition.
Assessment and Diagnosis
Triage
If you have signs or symptoms of congenital heart disease or were treated for a congenital heart defect as a child, you should make an appointment to see your health care provider. Symptoms in adults may include irregular heart rhythms (arrhythmias), blue skin, lips, and fingernails (cyanosis), shortness of breath, feeling tired quickly with activity, and swelling of body tissue or organs (edema). If you're experiencing worrisome symptoms such as chest pain or shortness of breath, seek emergency medical attention.
Diagnosis
To diagnose congenital heart disease in adults, your healthcare provider will first perform a physical exam and listen to your heart with a stethoscope. They may also ask questions about your symptoms and medical and family history. Additional tests to diagnose or confirm congenital heart disease in adults include an electrocardiogram (ECG), chest X-ray, and pulse oximetry. Cardiac CT scan, MRI, and cardiac catheterization may also be used to evaluate the condition.
Management and Treatment
Complications
Complications of adult congenital heart disease may include:
- Irregular heartbeats (arrhythmias): Faulty heart signaling can cause the heart to beat too fast, too slowly, or irregularly. Severe arrhythmias can lead to stroke or sudden cardiac death if left untreated. Scar tissue from previous surgeries can also contribute to this complication.
- Heart infection (endocarditis): Bacteria or other germs can enter the bloodstream and settle on the inner lining of the heart. If left untreated, this infection can damage heart valves or cause a stroke. High-risk individuals may be advised to take antibiotics before dental procedures to prevent infection.
- Stroke: A congenital heart defect can allow a blood clot to pass through the heart and travel to the brain, reducing or blocking blood supply.
- Heart failure: The heart may not be able to pump enough blood to meet the body's needs, leading to fluid buildup in the lungs, abdomen, legs, and feet (edema).
- Developmental problems related to the brain and nervous system: Some congenital heart defects may affect the flow of blood and oxygen to the brain, leading to developmental delays or neurological issues.
- Need for additional heart surgery or a heart transplant: In some cases, the original surgery may not fully correct the heart defect, or the heart may need additional procedures over time. In severe cases, a heart transplant may be necessary. Regular checkups with a heart doctor experienced in treating congenital heart disease (pediatric cardiologist or adult congenital cardiologist) are essential for managing these complications and ensuring the best possible quality of life.
Home Remedies
on home remedies specifically for adult congenital heart disease. It is important to follow the advice of a healthcare professional, such as a pediatric cardiologist or adult congenital cardiologist, who is trained in caring for people with congenital heart disease. They will be able to provide guidance on managing the condition, including any necessary medications or treatments.
Treatment
Treatments for adult congenital heart disease may include regular checkups, medications, or surgery. Some types of congenital heart disease may be mild and may not require treatment, while more complex defects may necessitate intervention. The specific treatment plan will depend on the type and severity of the congenital heart disease. Lifelong medical care is necessary for those with adult congenital heart disease, and it's important to have regular checkups with a heart doctor trained in caring for people with congenital heart disease, such as a pediatric cardiologist or adult congenital cardiologist. Medications may be used to manage symptoms, prevent blood clots, or control irregular heart rhythms. Surgery may be necessary to repair or replace damaged heart valves, close holes in the heart, or reroute blood flow to improve oxygenation.
Preparing for medical consultation
To prepare for an appointment for adult congenital heart disease, you should make an appointment with a cardiologist experienced in diagnosing and treating heart conditions. Before the appointment, gather information about your symptoms, personal and family medical history, all medications being taken, and any questions you have for your healthcare provider. Be prepared to discuss your symptoms and medical history, and ask any questions you may have. It's also helpful to bring along a family member or friend for support and to help remember information discussed during the appointment.