Journal Article

The changing epidemiology of congenital heart disease

Zwinderman, Aeilko H., van der Bom, Teun, Zomer, A. Carla, Mulder, Barbara J. M., Meijboom, Folkert J., Bouma, Berto J.

2011

Overview

Congenital heart disease is the most frequent of congenital disorders in newborns. Reliable epidemiological data for congenital heart disease, however, have been difficult to obtain owing to divergences in definitions, classifications, and methodologies of different studies. The authors of this Review discuss the latest changes in the epidemiology of congenital heart disease and its complications. Congenital heart disease is the most common congenital disorder in newborns. Advances in cardiovascular medicine and surgery have enabled most patients to reach adulthood. Unfortunately, prolonged survival has been achieved at a cost, as many patients suffer late complications, of which heart failure and arrhythmias are the most prominent. Accordingly, these patients need frequent follow-up by physicians with specific knowledge in the field of congenital heart disease. However, planning of care for this population is difficult, because the number of patients currently living with congenital heart disease is difficult to measure. Birth prevalence estimates vary widely according to different studies, and survival rates have not been well recorded. Consequently, the prevalence of congenital heart disease is unclear, with estimates exceeding the number of patients currently seen in cardiology clinics. New developments continue to influence the size of the population of patients with congenital heart disease. Prenatal screening has led to increased rates of termination of pregnancy. Improved management of complications has changed the time and mode of death caused by congenital heart disease. Several genetic and environmental factors have been shown to be involved in the etiology of congenital heart disease, although this knowledge has not yet led to the implementation of preventative measures. In this Review, we give an overview of the etiology, birth prevalence, current prevalence, mortality, and complications of congenital heart disease. Key Points The etiology of most forms of congenital heart disease is incompletely understood Genetic and environmental factors probably interact in the etiology of most nonsyndromal forms of congenital heart disease Epidemiological studies in congenital heart disease are hampered by diverging definitions, classifications, and methodology Birth prevalence estimates vary widely according to different studies, but this measure seems to be declining overall The prevalence of congenital heart disease is increasing The reported prevalence does not reflect the number of patients currently receiving care for congenital heart disease

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/420 / 692/699/75/1539 / 692/700/478/174 / Adolescent / Adult / Cardiac Imaging / Cardiac Surgery / Cardiac Surgical Procedures / Cardiology / Child / Child, Preschool / Congenital heart disease / Continuity of Patient Care / Diagnosis / Epidemiology / Health aspects / Heart Defects, Congenital - classification / Heart Defects, Congenital - epidemiology / Heart Defects, Congenital - etiology / Heart Defects, Congenital - mortality / Heart Defects, Congenital - therapy / Humans / Infant / Infant, Newborn / Medicine / Medicine & Public Health / Pregnant women / Prevalence / Reoperation / review-article / Risk Assessment / Risk Factors / Survival Analysis / Survival Rate / Terminology as Topic / Time Factors / Treatment Outcome / Young Adult