Heart failure in grown-up congenital heart disease

Area of Science:

• Cardiology
• Adult Congenital Heart Disease (ACHD)

Background:

• Increasing survival rates in congenital heart disease (CHD) have shifted focus to adult populations (ACHD).
• Adult congenital heart disease patients experience rising hospitalization rates due to heart failure (HF).
• ACHD patients with HF face a five-fold higher mortality risk compared to compensated patients.

Purpose of the Study:

• To highlight the unique challenges in diagnosing and managing heart failure (HF) in adult congenital heart disease (ACHD) patients.
• To emphasize the need for specialized monitoring and management strategies for HF in ACHD.

Main Methods:

• Review of current diagnostic and therapeutic strategies for HF in ACHD.
• Analysis of HF prevalence in specific ACHD conditions like tetralogy of Fallot, single ventricles, and post-Mustard operation.

Main Results:

• Heart failure predominantly affects ACHD patients with specific conditions, including tetralogy of Fallot, single ventricles, and those post-Mustard operation.
• Standard diagnostic and therapeutic approaches for acquired HF may not be fully adequate or timely for ACHD patients.
• Unusual signs and symptoms can delay HF identification in ACHD.

Conclusions:

• Dedicated monitoring units are essential for timely HF identification and management in ACHD.
• Current therapeutic management for HF in ACHD mirrors acquired HF, despite a lack of specific large randomized trials.
• Proactive and specialized care is imperative for improving outcomes in ACHD patients with heart failure.