Congenital heart disease: origin, incidence and adult presentation
THE CONTEXT
Congenital heart disease may originate during cardiac formation or during the normal anatomical transition from fetal to newborn circulation.
Origin and frequency
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Congenital heart disease can result from defects in formation of the heart or great vessels, or from failure of the anatomical changes normally occurring between fetal and newborn life.
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Haemodynamically significant congenital cardiac abnormalities occur in an estimated 0.8% of live births.
Presentation and survival
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Presentation usually occurs in childhood, but some patients first present in adulthood.
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Well-tolerated defects, such as atrial septal defect, may remain asymptomatic until adult life or be detected incidentally during routine examination or chest X-ray.
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Correction or partial correction of defects previously fatal in childhood means that survival into adulthood is now the norm.
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Patients may remain well for many years after correction and subsequently present with related problems, including arrhythmia or heart failure.