The Adult Patient with Congenital Heart Disease in the Emergency Department

It is well recognized that adult survivors with congenital heart disease are at risk for several cardiac and noncardiac complications that can impact their long-term outcomes. Emergency departments are increasingly being used for the evaluation and management of acute complications in these patients. However, there are several issues that are unique to adults with congenital heart disease related to the complexity of their cardiac anatomy, previous surgical intervention, and residual hemodynamic lesions that can complicate their presentation and management. This review examines the many challenges faced in caring for adults with congenital heart disease presenting to the emergency department, including the issues related to underlying cardiac lesion, access to care, and the evaluation and management of common clinical presentations.