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Heart failure in congenital heart disease: management options and clinical challenges

Elsbeth M Leusveld1, Robert M Kauling1, Laurie W Geenen1

  • 1Department of Cardiology, Erasmus Medical Center , Rotterdam, The Netherlands.

Expert Review of Cardiovascular Therapy
|July 21, 2020
PubMed

Insights

Adults with congenital heart disease (ACHD) face heart failure risks. Early diagnosis using various tests and advanced care planning are vital for managing this growing population.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease (ACHD)

Background:

  • The population of adults with congenital heart disease (ACHD) is expanding.
  • Heart failure is a major complication in ACHD patients.
  • Evidence for effective heart failure treatments in ACHD is limited.

Purpose of the Study:

  • To provide an overview of current insights in ACHD.
  • To cover epidemiology, diagnosis, risk stratification, and treatment options.
  • To include non-medical therapies and advanced care planning.

Main Methods:

  • Review of current available insights.
  • Analysis of diagnostic components: medical history, physical examination, ECG, echocardiography, cardiac MRI, exercise testing, and biomarkers.
  • Synthesis of information on treatment options and advanced care planning.

Main Results:

  • Various diagnostic tools can identify ACHD patients at risk for mortality or heart failure.
  • Current clinical questions in ACHD management require further research.
  • Expanding the use of biomarkers and advanced care planning is recommended.

Conclusions:

  • Biomarkers should be more widely used in the diagnostic process for ACHD.
  • Timely discussion of advanced treatment options and care planning is crucial for ACHD patients.
  • Multi-center research collaborations are necessary to address all aspects of ACHD care.
Abstract

Keywords:
Risk stratificationbiomarkerscongenital Heart Defectsdiagnosisheart failurepredictorsprognosistreatment

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