Hot Topics — The adult with congenital heart disease: Indications for referral

Sabrina D. Phillips, M.D., Mayo Clinic cardiologist specializing in adult congenital heart disease, reviews the importance of ongoing cardiac care for adults who have transitioned from pediatric cardiology care. Congenital heart disease affects about 1 percent of live births, and with the improvements in medical and surgical care over the last three decades, most patients, even with severe defects, will survive to adulthood.

Currently in the United States, there are more adults living with congenital heart defects than there are children. Many adults with congenital heart disease require expert subspecialty cardiac care in a tertiary care facility with access to a multidisciplinary care team to achieve and maintain optimum health. However, many patients are lost to care as they transition to adulthood. The point of contact for return to medical care may be a provider other than a cardiologist. Patients most at risk to be lost to cardiology care are those that perceive that they are “cured” or who do not identify their cardiac defect as severe. The challenge for providers encountering these patients is recognizing who needs referral to an adult congenital heart disease subspecialty clinic if the patient is not presenting with a cardiac complaint. Dr. Phillips shares flags for the clinician to recognize who needs a referral to a specialist in adult congenital heart disease.

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