title: Common long-term complications of adult congenital heart disease: avoid falling in a H.E.A.P.
abstract: Advances in cardiology and cardiac surgery have transformed the outlook for patients with congenital heart disease (CHD) so that currently 85% of neonates with CHD survive into adult life. Although early surgery has transformed the outcome of these patients, it has not been curative. Heart failure, endocarditis, arrhythmias and pulmonary hypertension are the most common long term complications of adults with CHD. Adults with CHD benefit from tertiary expert care and early recognition of long-term complications and timely management are essential. However, it is as important that primary care physicians and general adult cardiologists are able to recognise the signs and symptoms of such complications, raise the alarm, referring patients early to specialist adult congenital heart disease (ACHD) care, and provide initial care. In this paper, we provide an overview of the most commonly encountered long-term complications in ACHD and describe current state of the art management as provided in tertiary specialist centres.
authors.affiliation: a Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension , Royal Brompton Hospital , London , UK.|b NIHR Cardiovascular Biomedical Research Unit , Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London , London , UK.|c National Heart and Lung Institute , Imperial College School of Medicine , London , UK.
authors.forename: M
authors.initials: M
authors.lastname: Ministeri
authors.affiliation: a Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension , Royal Brompton Hospital , London , UK.|b NIHR Cardiovascular Biomedical Research Unit , Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London , London , UK.|c National Heart and Lung Institute , Imperial College School of Medicine , London , UK.
authors.forename: R
authors.initials: R
authors.lastname: Alonso-Gonzalez
authors.affiliation: a Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension , Royal Brompton Hospital , London , UK.|b NIHR Cardiovascular Biomedical Research Unit , Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London , London , UK.|c National Heart and Lung Institute , Imperial College School of Medicine , London , UK.
authors.forename: L
authors.initials: L
authors.lastname: Swan
authors.affiliation: a Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension , Royal Brompton Hospital , London , UK.|b NIHR Cardiovascular Biomedical Research Unit , Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London , London , UK.|c National Heart and Lung Institute , Imperial College School of Medicine , London , UK.
authors.forename: K
authors.initials: K
authors.lastname: Dimopoulos
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D042241:Early Diagnosis; D061345:Early Medical Intervention; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D000069451:Long Term Adverse Effects / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D017741:Survivors
keywords: Congenital heart disease; adult congenital heart disease; arrhythmia; complications; endocarditis; heart failure; pulmonary hypertension