Adults with congenital heart disease (CHD) generally fall into two categories: patients who have been recognized, treated, and followed during their pediatric years and subsequently require follow-up during their adult years; and the de novo, previously unrecognized adults who may or may not be symptomatic at the time of diagnosis. Despite the complexity of this patient population and a well-defined need for subspecialty care, the average adult with CHD is followed primarily by a generalist. It is essential, therefore, that all physicians be familiar with the unique clinical presentations of these patients and have a general understanding of their anatomy and its consequences to facilitate the proper timing of referral for percutaneous, electrophysiologic, and surgical interventions.
The clinical course of CHD in the adult is most dependent on the anatomic lesions present and the timing and manner of repair. These lesions can be divided into three general categories
- Simple shunt Lesions
- Obstructive Lesions
- Complex Lesions (acyanotic and cyanotic)