Adult Congenital Heart Disease (ACHD) Overview: genetic heart disease, born with heart problems, achd, congenital heart defects classification

Adult Congenital Heart Disease (ACHD) - What it is

adult congenital heart disease condition and treatment

An increasing number of children with congenital heart disease are surviving into adulthood due to greatly improved surgical, medical, anaesthetic and intensive care over the last few decades. The survival of congenital patients into adulthood is now more than 90% in comparison to the 25% survival rate around fifty years ago. As this new group of patients enters adulthood, they will need regular monitoring and ongoing care, and sometimes may even require further surgical interventions.

With the exception of a few procedures – ligation of isolated patent ductus arteriosus (PDA), closure of isolated atrial septal defects (ASD) and ventricular septal defects (VSD) – surgical treatment of congenital heart disease is more often palliative than curative. Repeated procedures and interventions are the norms as conduits, baffles, shunts and grafts become narrowed, blocked and incompetent with time. In addition to the medical and surgical issues, this growing population may also face specific social, psychological and behavioural problems throughout their life.

The timely establishment of adult congenital heart disease (ACHD) (also known as congenital heart disease in adults) as a subspecialty of cardiology will help people living with ACHD to improve their quality of life.

Congenital Heart Defects Classification

Blood circulation in a normal heart.

There are many types of congenital heart defects and these can be classified into four main categories:

1) Right to left shunts/ Cyanotic heart defects

The heart is made up of four chambers – two on the left and two on the right. Typically, the left and right side of the heart are separate from each other. The left side of the heart delivers oxygen-rich blood from the lungs to the body while the right side of the heart receives oxygen-poor blood from the rest of the body and transports it to the lungs.

However, in right to left shunts, an unusual link between the right and left sides of the heart causes blood to flow from the right to left side of the heart. This reduces the amount of oxygen in the blood circulating in the body, resulting in a bluish tint to the skin (cyanosis).

Tetralogy of Fallot
Ebstein’s anomaly
Pulmonary atresia
Tricuspid atresia

2) Left to right shunts

In left to right shunts, there is an unusual link between the right and left sides of the heart which causes blood to flow from the left side of the heart to the right. This results in an excess amount of blood in the right side of the heart and as such, excessive blood flow to the lungs.
Patent Ductus Arteriosus (PDA)
Atrial septal defect
Ventricular septal defect
Atrio-Ventricular defect
Aorto-pulmonary window

3) Blood flow obstruction
These are conditions where faulty heart valves or blood vessels block the flow of blood in or out of the heart.
Mitral valve stenosis
Coarctation of Aorta
Congenital pulmonary stenosis
Congenital aortic stenosis
Interrupted aortic arch