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Resource Center
Special Topics & Concerns

Topics listed below include:

• Arrhythmia
• CHD and Pregnancy
• Cyanotic CHD
• Endocarditis
• Exercise/Physical Activity
• Not Sure What You Have?
• Pulmonary Hypertension

Arrhythmia
An arrhythmia is an abnormal heart rhythm, either fast or slow. It can be in either the upper chambers of the heart (atria) or the lower chamber of the heart (ventricles). The links below will provide you with additional information.

• American Heart Association: Arrhythmias
• Cardiac Arrhythmias Research and Education Foundation, Inc.
• Internet Medical Education, Inc.: Atrial Fibrillation
• Abstract
  Kanter RJ, Garson A Jr. Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease. Pacing Clin Electrophysiol. 1997 Feb; 20(2 Pt 2): 502-511.
• Li W, Xiao HB, Henein MY, Somerville J, Gibson DG. Progressive ECG changes before the onset of atrial flutter in adult congenital heart disease patients. Heart. 2001 Jun; 85(6): 703.
• Long QT Syndrome
• National Marfan Foundation: Cardiac Concerns
• SADS Foundation
• Abstract
  Thorne SA, Barnes I, Cullinan P, Somerville J. Amiodarone-associated thyroid dysfunction: risk factors in adults with congenital heart disease. Circulation. 1999 Jul 13; 100(2): 149-154.
• Abstract
  Warfield DA, Hayes DL, Hyberger LK, Warnes CA, Danielson GK. Permanent pacing in patients with univentricular heart. Pacing Clin Electrophysiol. 1999 Aug; 22(8): 1193-1201.

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CHD and Pregnancy
Women with congenital heart defects (CHD) now make up the majority of patients with heart disease seen in pregnancy. Pregnancy is well tolerated in many patients with CHD. However, pregnancy in some cases poses a high risk for significant cardiovascular complications and even death. It is highly recommended that any CHD patient contemplating pregnancy should consult with an ACHD specialist.

• Abstract from the National Library of Medicine's PubMed
  Allan LD, Crawford DC, Chita SK, Anderson RH, Tynan MJ. Familial recurrence of congenital heart disease in a prospective series of mothers referred for fetal echocardiography. Am J Cardiol. 1986 Aug 1; 58(3): 334-337.
• AHA: Sex, Pregnancy and Birth Control
• Abstract
  Boneva RS, Moore CA, Botto L, Wong LY, Erickson JD. Nausea during pregnancy and congenital heart defects: a population-based case-control study. Am J Epidemiol. 1999 Apr 15; 149(8): 717-725.
• Abstract
  Canobbio MM. Reproductive issues for the woman with congenital heart disease. Nurs Clin North Am. 1994 Jun; 29(2): 285-297.
• Canobbio MM, Mair DD, Rapkin AJ, Perloff JK, George BL. Menstrual patterns in females after the Fontan repair. Am J Cardiol. 1990 Jul 15; 66(2): 238-240.
• Abstract
  Canobbio MM, Mair DD, van der Velde M, Koos BJ. Pregnancy outcomes after the Fontan repair. J Am Coll Cardiol. 1996 Sep; 28(3): 763-767.
• Abstract
  Clarkson PM, Wilson NJ, Neutze JM, North RA, Calder AL, Barratt-Boyes BG. Outcome of pregnancy after the Mustard operation for transposition of the great arteries with intact ventricular septum. J Am Coll Cardiol. 1994 Jul; 24(1): 190-193.
• Abstract
  Connolly HM; Grogan M; Warnes CA. Pregnancy among women with congenitally corrected transposition of great arteries. J Am Coll Cardiol. 1999 May; 33(6): 1692-1695.
• Abstract
  Connolly HM, Warnes CA. Outcome of pregnancy in patients with complex pulmonic valve atresia. Am J Cardiol. 1997 Feb 15; 79(4): 519-521.
• Abstract
  Connolly HM, Warnes CA. Ebstein's anomaly: outcome of pregnancy. J Am Coll Cardiol. 1994 Apr; 23(5): 1194-1198.
• Abstract
  Genoni M, Jenni R, Hoerstrup SP, Vogt P, Turina M. Pregnancy after atrial repair for transposition of the great arteries. Heart. 1999 Mar; 81(3): 276-277.
• Lockhart EM, Penning DH, Olufolabi AJ, Bell EA, Booth JV, Kern FH. SvO2 monitoring during spinal anesthesia and cesarean section in a parturient with severe cyanotic congenital heart disease. Anesthesiology. 1999 Apr; 90(4): 1213-1215.
• Abstract
  Megerian G, Bell JG, Huhta JC, Bottalico JN, Weiner S. Pregnancy outcome following Mustard procedure for transposition of the great arteries: a report of five cases and review of the literature. Obstet Gynecol . 1994 Apr; 83(4): 512-516.
• Abstract
  Neumayer U, Somerville J. Outcome of pregnancies in patients with complex pulmonary atresia. Heart 1997 Jul; 78(1): 16-21.
• Congenital heart disease and pregnancy
  Perloff JK. Congenital heart disease and pregnancy. Clin Cardiol. 1994 Nov; 17(11): 579-587.
• Abstract
  Presbitero P, Somerville J, Stone S, Aruta E, Spiegelhalter D, Rabajoli F. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation. 1994 Jun; 89(6): 2673-2676.
• Abstract
  Saidi AS, Bezold LI, Altman CA, Ayres NA, Bricker JT. Outcome of pregnancy following intervention for coarctation of the aorta. Am J Cardiol. 1998 Sep 15; 82(6): 786-788.
• Abstract
  Shime J, Mocarski EJ, Hastings D, Webb GD, McLaughlin PR. Congenital heart disease in pregnancy: short- and long-term implications. Am J Obstet Gynecol. 1987 Feb; 156(2): 313-322. Published erratum appears in Am J Obstet Gynecol. 1987 May; 156(5): 1361.
• Women with heart defects lack info on pregnancy safety
  Women with heart defects lack info on pregnancy safety. Macleans.ca Health. Nov 20, 2006.
• Abstract
  Zuber M, Gautschi N, Oechslin E, Widmer V, Kiowski W, Jenni R. Outcome of pregnancy in women with congenital shunt lesions. Heart. 1999 Mar; 81(3): 271-275.

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Cyanotic CHD
Some types of CHD result in cyanosis or bluing of the skin secondary to the fact that blood pumped to the body does not have enough oxygen. The following resources provide information about cyanotic CHD.

• Abstract
  Ammash N, Warnes CA. Cerebrovascular events in adult patients with cyanotic congenital heart disease. J Am Coll Cardiol. 1996 Sep; 28(3): 768-772.
• Abstract
  Armstrong BE. Congenital cardiovascular disease and cardiac surgery in childhood: Part 1. Cyanotic congenital heart defects.
• Abstract
  Burlet A, Drukker A, Guignard JP. Renal function in cyanotic congenital heart disease. Nephron. 1999; 81(3): 296-300.
• Abstract
  Miner PD, Canobbio MM. Care of the adult with cyanotic congenital heart disease. Nurs Clin North Am 1994 Jun; 29(2): 249-267.
• Uzark K. Cyanotic congenital heart disease with decreased pulmonary blood flow. Nurs Clin North Am. 1984 Sep; 19(3): 503-519.

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Endocarditis
Endocarditis is an inflammation or infection of the inner lining of the heart. The resources below will provide you with more information.

• AHA: Endocarditis Prophylaxis Information
• Abstract
  Cetta F, Graham LC, Lichtenberg RC, Warnes CA. Piercing and tattooing in patients with congenital heart disease: patient and physician perspectives. J Adolesc Health. 1999 Mar; 24(3): 160-162.
• Abstract
  Cetta F, Podlecki DC, Bell TJ. Adolescent knowledge of bacterial endocarditis prophylaxis. J Adolesc Health. 1993 Nov; 14(7): 540-542.
• Abstract
  Cetta F, Warnes CA. Adults with congenital heart disease: patient knowledge of endocarditis prophylaxis. Mayo Clin Proc. 1995 Jan; 70(1): 50-54.

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Exercise/Physical Activity
The following resources on exercise and physical activity are available for your information. Please consult your ACHD specialist before starting an exercise program.

• AHA: Keeping Your Heart Healthy
• AHA: Physical Activity and Exercise
• AHA: Cardiovascular Preparticipation Screening of Competitive Athletes
• Abstract
  Beekman RH. Exercise recommendations for adolescents after surgery for congenital heart disease. Pediatrician 1986; 13(4): 210-219.
• Fratellone PM, et al. Exercise and congenital heart disease. Am Heart J. 1994 Jun; 127(6): 1676-1680.
• Exercise capacity in adult patients with congenitally corrected transposition of the great arteries
  Fredriksen PM, Veldtman G, Hechter S, Therrien J, Chen A, Warsi MA, Freeman M, Liu P, Siu S, Thaulow E, Webb G. Aerobic capacity in adults with various congenital heart diseases. Am J Cardiol. 2001 Feb 1; 87(3): 310-314.
• Abstract
  Fredriksen PM, Chen A, Veldtman G, et al. Exercise capacity in adult patients with congenitally corrected transposition of the great arteries. Heart. 2001 Feb; 85(2): 191-195.
• Kitchiner D. Physical activities in patients with congenital heart disease. Heart. 1996 Jul; 76(1): 6-7.
• Abstract
  Koster NK. Physical activity and congenital heart disease. Nurs Clin North Am. 1994 Jun; 29(2): 345-356.
• Abstract
  Liberthson RR. Arrhythmias in the athlete with congenital heart disease: guidelines for participation. Annu Rev Med. 1999; 50: 441-452.

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Not Sure What You Have?
Did your parents ever tell you that you that you had heart surgery as a child but you don't know any details about it? Are you unsure why you went to the doctor so much when you were a child? Are you wondering why you have a scar on your chest?

It is possible you were born with a congenital heart defect (CHD). For your continued well-being, it is important to know what type of CHD you have. You might be asking, "How do I find this information?" There are several things you can do:

• Ask your parents, siblings, aunt, uncles, or other relatives about your surgery and ask them for the details, such as your doctor’s name or the name of the hospital where you had surgery;
• Request your medical records from the doctor or hospital where you received care as a child;
• Make an appointment with an adult congenital heart specialist for a detailed evaluation and diagnosis.

Additional information about CHD can be found in our Resources Center. The ACHA Clinic Directory is available to members.

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Pulmonary Hypertension
Pulmonary Hypertension (PHT) occurs when there is high blood pressure in the arteries that supply the lungs. PHT caused by another disease, such as CHD, is known as secondary hypertension.

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