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Review
. 2022 Oct 17;1(6):274-281.
doi: 10.1016/j.cjcpc.2022.10.002. eCollection 2022 Dec.

Caring for the Aging Patient With Adult Congenital Heart Disease: A Review of Cardiac and Noncardiac Comorbidities

Michelle Keir  1 , Meredith Borman  2 , Robin Clegg  1 , Jillian Colbert  1 , Nita Guron  1 , Lea Harper  3 , Doug Helmerson  3 , Jessica Patzer  1 , Stephen Reynolds  1 , Nanette Alvarez  1
Affiliations
Review

Caring for the Aging Patient With Adult Congenital Heart Disease: A Review of Cardiac and Noncardiac Comorbidities

Michelle Keir et al. CJC Pediatr Congenit Heart Dis. .

Abstract
in English, French

As the demographics of congenital heart disease (CHD) have shifted, there are now more adults living with CHD than children in North America. This presents unprecedented challenges as patients with CHD acquire noncardiac comorbidities and seek care for a variety of reasons, including noncardiac surgery and emergency department (ED) visits. CHD shifts from a one organ problem to a multisystem disease and requires a team of specialists to maintain high-quality longitudinal care. In this review, we summarize the challenges patients with CHD and their providers face as they age. We review the demographics of CHD and health care utilization. We examine the rates of noncardiac comorbidities and the current quality of care received by adult patients with CHD.

Les caractéristiques démographiques des patients atteints d’une cardiopathie congénitale ont changé : à l’heure actuelle, en Amérique du Nord, il y a plus d’adultes qui présentent une cardiopathie congénitale que d’enfants. Cela représente un défi sans précédent lorsque ces patients ont des troubles concomitants non cardiaques et doivent subir une chirurgie non cardiaque, par exemple, ou se rendre aux urgences pour toutes sortes de raisons. On ne parle alors plus de l’atteinte d’un seul organe, mais bien d’une maladie multisystémique. Une équipe pluridisciplinaire sera nécessaire pour maintenir des soins longitudinaux de haute qualité.Dans notre article, nous faisons le point sur les défis que les personnes atteintes d’une cardiopathie congénitale et les dispensateurs de soins doivent affronter à mesure que le patient avance en âge. Nous passons en revue les données démographiques sur les cardiopathies congénitales ainsi que celles sur l’utilisation des services de santé. Nous examinons la fréquence des comorbidités non cardiaques, tout comme la qualité des soins que reçoivent actuellement les patients atteints d’une cardiopathie congénitale.

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Figures

Figure 1
Figure 1
The disconnect between chronological age (what we expect) and biologic age (true functioning) in young adults living with congenital heart disease.
Figure 2
Figure 2
Not just the heart; adult congenital heart disease has become a multisystem disease as patients reach older age.
Figure 3
Figure 3
Triad of risk in patients with adult congenital heart disease (ACHD) presenting to the emergency department.
See this image and copyright information in PMC

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