Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

• Published in: Circulation (New York, N.Y.) Vol. 136; no. 20; pp. e348 - e392
• Main Authors: Lui, George K, Saidi, Arwa, Bhatt, Ami B, Burchill, Luke J, Deen, Jason F, Earing, Michael G, Gewitz, Michael, Ginns, Jonathan, Kay, Joseph D, Kim, Yuli Y, Kovacs, Adrienne H, Krieger, Eric V, Wu, Fred M, Yoo, Shi-Joon
• Format: Journal Article
• Language: English
• Published: United States by the American College of Cardiology Foundation and the American Heart Association, Inc 14.11.2017
• Subjects: Adult; Age Factors; American Heart Association; Disease Management; Heart Defects, Congenital - complications; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - therapy; Humans; Kidney Diseases - diagnosis; Kidney Diseases - etiology; Kidney Diseases - therapy; Liver Diseases - diagnosis; Liver Diseases - etiology; Liver Diseases - therapy; United States; heart defects, congenital; prevention and control; heart diseases; AHA Scientific Statements
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIR.0000000000000535

Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.