Genetic counseling for young adults who have a congenital heart defect

Early individual guidance is needed for all adolescents and young adults with congenital heart defects. This should include not only a personal interest in the individual but also an attempt to identify concerns about sex education, smoking, drugs and the risks of pregnancy and possible inheritance. In a prospective study of 252 women with various cardiac malformations, the incidence of congenital heart defects in their progeny was 15.7% (13% exclusive of genetic syndromes and those with a positive family history). In those with a positive family history or a genetic syndrome the incidence was 56% in the offspring. Genetic syndromes with cardiac components are increasingly apparent. The role of teratogens such as medications, illicit drugs, and environmental exposure play a not yet clearly defined role. Careful discussion with potential parents, giving facts but with a positive approach, is an obligation of every physician.