ACR appropriateness criteria on suspected congenital heart disease in adults

Area of Science:

• Cardiology
• Medical Imaging

Background:

• The prevalence of adults with congenital heart disease (CHD) is increasing, particularly in North America.
• Improvements in surgical interventions and immigration patterns contribute to this demographic shift.
• Accurate assessment and ongoing monitoring are crucial for managing adult CHD.

Purpose of the Study:

• To highlight the critical role of cardiac imaging in the evaluation of adult congenital heart disease.
• To discuss the evolution and integration of various imaging modalities in managing adult CHD.
• To emphasize the benefits of noninvasive imaging for serial assessment and surveillance.

Main Methods:

• Review of current practices in adult congenital heart disease assessment.
• Discussion of the utility of chest radiography and echocardiography as initial tools.
• Analysis of the advancements and applications of cardiac computed tomography (CT) and magnetic resonance imaging (MRI).

Main Results:

• Chest radiography and echocardiography remain primary diagnostic tools for initial evaluation.
• Cardiac CT and MRI have become integral, offering detailed noninvasive assessment.
• Advanced imaging often obviates the need for invasive cardiac catheterization.
• Noninvasive imaging is vital for surveillance in patients with surgically corrected CHD.

Conclusions:

• Cardiac imaging is indispensable for both the initial diagnosis and long-term management of adults with congenital heart disease.
• Modern noninvasive imaging techniques, particularly CT and MRI, significantly enhance diagnostic capabilities and patient care.
• These advancements reduce the reliance on invasive procedures and improve surveillance for complex adult CHD cases.