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The adult patient with congenital heart disease 

The adult patient with congenital heart disease
The adult patient with congenital heart disease

Robyn Smith

and Niki Walker

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date: 19 September 2020

This chapter describes the role of the cardiac intensive care unit (CICU) in the management of adult patients with congenital heart disease (ACHD). This is a growing population as possibly 90% of infants with congenital heart disease now survive to adulthood. Patients with ACHD may present to CICU in three circumstances: postoperatively following cardiac intervention, postoperatively following non-cardiac surgery, and during the management of a medical emergency. Specialist expertise on the physiological consequences of the abnormal cardiac anatomy can optimize the CICU outcome. The chapter presents a glossary and description of common congenital syndromes and descriptors. It goes on to consider management of key problems including arrhythmias, cyanosis, haemoptysis, and heart failure. It outlines the general principles of care in patients with ACHD and discusses the implications of some important specific conditions: tetralogy of Fallot, transposition of the great arteries, and the Fontan circulation.

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