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[Congenital heart defects also in adulthood?]
1Medizinische Klinik B, Stiftsklinik Augustinum München.
Insights
Undiagnosed congenital heart disease is rare in adults, but more children undergo heart surgery. Atrial septal defects and ventricular septal defects are common adult diagnoses, sometimes detected during hypertension workups.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease
- Diagnostic Imaging
Context:
- Congenital heart disease (CHD) is rarely undetected in adulthood, accounting for less than 1% of cases.
- However, the number of patients undergoing surgery for these conditions during childhood or adolescence is increasing.
- Common CHDs diagnosed in adulthood include atrial septal defects (ASDs) and ventricular septal defects (VSDs).
Purpose:
- To highlight the diagnostic challenges and increasing prevalence of adult-diagnosed congenital heart disease.
- To emphasize the role of echocardiography and non-invasive methods in diagnosing and assessing hemodynamic changes.
- To inform clinical decision-making regarding surgical intervention for adult-onset CHDs.
Summary:
- While most congenital heart diseases are detected early, a small percentage are diagnosed in adulthood.
- Atrial septal defects and ventricular septal defects are the most frequent diagnoses in this population.
- Other conditions like left ventricular outflow tract anomalies and coarctation of the aorta may also be identified later in life, often during investigations for hypertension.
Impact:
- Echocardiography is crucial for diagnosing adult-onset CHDs.
- Non-invasive assessment of hemodynamic changes aids surgical decisions.
- Increased awareness and diagnostic capabilities improve management of adult congenital heart patients.
Abstract:
Congenital heart diseases that escape detection are a rarity in adulthood (less than 1%). The number of patients with such abnormalities operated on during childhood or adolescence is, in contrast, on the increase. The most common heart abnormalities diagnosed for the first time in adulthood are atrial septal and ventricular septal defects, but anomalies of the left ventricular outflow tract or coarctation of the aorta is sometimes also detected only in adulthood on the occasion of an investigation of hypertension. In addition to the findings at auscultation, clinical pictures, ECG and chest X-ray, echocardiography is becoming ever decisive for the diagnostic work-up. Further, the extent of the haemodynamic changes can now be determined non-invasively, and may thus tip the balance when deciding for and against an operation.