成人期先天性心臓病の問題点 : 修学,就職,妊娠,出産

Congenital heart diseases comprise a wide spectrum heart disease with varying levels of severity. More complex condition, such as post Fontan patients with univentricular heart, requires lifelong follow up care by various kind of doctors, including pediatric cardiologist, obstetrician and gynecologist, internal medicine specialist, and cardiovascular surgeon. In addition to the medial problems, many patients with congenital heart disease are facing specific psychological, educational, and behavioral challenges and issues. The outcome of pregnancy is favorable in most women with congenital heart disease, provided class and systemic ventricular function are good. A recent survey highlighted endocarditis and pulmonary hypertension as the major risk factors for maternal death. Arrhythmia, most commonly atrial flutter, is an increasingly important cause of morbidity and mortality. Management may require cardiac catheterization, electrophysiological mapping with ablation, cardiac surgery, or a combination of these approaches. Acquired heard disease（coronary arterial disease and systemic hypertension）will occur with increasing frequency as the population ages. These acquired heart diseases can also cause worsening symptoms on the congenital heart disease. These problems may be solved by providing the organized cardiac units stuffed by properly trained specialists in various fields.