Heart Failure in Adult Congenital Heart Disease Patients

New medical research and technology has improved the survival rate for people born with congenital heart disease (CHD). This means more people with CHD are living longer, but they face unique challenges. One of those challenges includes the potential for heart failure.

What Is Heart Failure?

Heart failure occurs when the heart cannot pump blood efficiently to meet the body’s needs.

In adults with CHD, this can result from long-term stress on the heart caused by structural abnormalities, prior surgeries or other complications, like arrhythmias. Over time, these factors can weaken the heart muscle, leading to symptoms of heart failure.

Causes of Heart Failure in CHD Patients

Heart failure can happen for different reasons. It depends on the type of defect and how complicated it is.

Common factors of heart failure include:

• Ventricular Dysfunction: Overworked heart chambers may weaken or stiffen over time.
• Valve Problems: Leaking or narrowed valves can force the heart to work harder.
• Arrhythmias: Irregular heart rhythms can strain the heart and reduce its efficiency.
• Surgical Scarring: Previous heart surgeries may lead to complications that affect heart function.

Recognizing the Symptoms

Heart failure symptoms can develop gradually or suddenly. Some of the symptoms to be aware of, include:

• Shortness of breath, especially during physical activity or when lying down.
• Swelling in the legs, ankles or abdomen (edema)
• Fatigue and weakness
• Difficulty exercising or performing daily activities
• Persistent cough or wheezing, especially at night
• Rapid or irregular heartbeat

If you notice these symptoms, it’s important to contact your health care provider immediately.

Diagnosis and Monitoring

There are multiple ways to diagnose heart failure in CHD patients. Typically, it involves a combination of the following:

• Physical Exams: Checking for signs of fluid buildup or irregular heartbeats.
• Imaging Tests: Echocardiograms, MRIs or CT scans to assess heart structure and function.
• Blood Tests: Measuring markers like BNP (B-type natriuretic peptide) to detect heart stress.
• Exercise Testing: Evaluating how well the heart responds to physical activity.

The most proactive way to manage heart failure is through regular monitoring with a congenital heart specialist.

Treatment Options

Treatment for heart failure often combines lifestyle changes, medications and advanced therapies. Options may include:

• Medications: ACE inhibitors, beta-blockers, diuretics and other drugs to improve heart function and relieve symptoms.
• Device Therapy: Pacemakers or implantable defibrillators to regulate heart rhythms.
• Catheter-based Procedures: To repair valve issues or other complications without surgery.
• Heart Transplant: In severe cases, a transplant may be considered if other treatments are not effective.

Living with Heart Failure

Managing heart failure requires a proactive approach. Adults with congenital heart disease can benefit from regular follow-up care with a cardiologist who understands their condition.

Making healthy lifestyle choices, such as eating a balanced diet, exercising regularly, avoiding smoking and excessive alcohol is also important. Additionally, having emotional support through support groups or counseling can help manage the challenges of living with heart failure.