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[Congenital cardiopathies at an internal medicine service]
1Serviço de Medicina I, Hospital de Santa Maria/Faculdade de Medicina de Lisboa.
Insights
Congenital heart disease (CHD) is more common in adults than previously thought, with atrial septal defects being the most frequent diagnosis. Early diagnosis and management are crucial for improving outcomes in adult CHD patients.
Area of Science:
- Cardiology
- Internal Medicine
- Adult Congenital Heart Disease
Context:
- Congenital heart disease (CHD) often presents in adulthood.
- Adult internal medicine departments manage a significant number of CHD cases.
- Understanding the spectrum of adult CHD is crucial for effective patient care.
Purpose:
- To describe the clinical characteristics of 32 adult patients with congenital heart disease.
- To analyze the types of CHD, diagnostic methods, and outcomes in this cohort.
- To highlight the prevalence of specific conditions like atrial septal defects (ASD) and bicuspid aortic valves.
Summary:
- A retrospective study of 32 adult patients admitted between 1980-1989 revealed diverse congenital heart conditions.
- Atrial septal defects (ASD) were the most common (59%), followed by bicuspid aortic valves and coarctation of the aorta.
- Congestive heart failure and atrial fibrillation were frequent complications, underscoring the need for vigilant monitoring in aging CHD populations.
Impact:
- This study emphasizes that congenital heart disease is not rare in adults and often presents with significant comorbidities.
- Echocardiography proved to be a valuable diagnostic tool for identifying these conditions.
- The occurrence of infective endocarditis in bicuspid aortic valves highlights the importance of prophylactic measures.
Study Objective:
Description of 32 cases of congenital heart disease in the adulthood, admitted in the First Department of Medicine of Hospital Santa Maria, Lisboa between 1980 and 1989.
Design:
Retrospective study.
Setting:
Admission from the Emergency Room and Outpatients Clinic to an Internal Medicine Department of a General Hospital.
Patients:
Adult patients with congenital heart disease.
Material And Methods:
All the 32 cases of congenital heart disease admitted between the 1st January 1980 and the 31st December 1989 were studied retrospectively. The clinical findings diagnosis and special examinations were analysed.
Main Results:
The admission age varied between 15 and 83 years old being 21 female (65.6%) and 11 males (34.4%). The 32 cases of congenital heart disease, were distributed as follows: 19 were atrial septal defects (ASD); 4 were bicuspid aortic valves; 3 were coarctations of the aorta; 3 were tetralogy of Fallot; 2 were patent ductus arteriosus; 1 was an Ebstein anomaly with cianosis. From the 19 cases of atrial septal defect (ASD), 15 were female and 4 were male. The mean age of admission was 57.1 +/- 14.9. Congestive heart failure (CHF) was the reason for admission in 11 cases. The EKG findings were atrial fibrillation (AF) in 11 cases and atrial flutter in 1. Pulmonary hypertension was observed in the 17 echocardiographically documented cases. Infeccious endocarditis was diagnosed in 2 of the 4 bicuspid aortic valves.
Conclusions:
Congenital heart disease is not a very rare disease. In our 32 cases, 19 (59%) were ASD. CHD and AF were very common in this patology, in relation to the advanced age of this population. The echocardiography was a very useful diagnostic procedure. The 2 infective endocarditis cases between the 4 bicuspid aortic valves, is a way to remember the importance of prophylaxis.