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先天性心脏病患者——一个新的、不断扩大的患者群体。

Adults With Congenital Heart Disease—a New, Expanding Group of Patients.

机构信息

Department of Congenital Heart Defects and Pediatric Cardiology, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; Department of Cardiology, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; Department of Cardiovascular Surgery, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; German Heart Center Berlin, Department of Congenital Heart Surgery - Pediatric Heart Surgery, Berlin; German Center for Cardiovascular Research, Partner Site Berlin, Germany; Department of Cardiology III: Adult Congenital and Valvular Heart Disease, University Hospital of Münster.

出版信息

Dtsch Arztebl Int. 2023 Mar 24;120(12):195-202. doi: 10.3238/arztebl.m2023.0006.

Abstract

BACKGROUND

Congenital heart anomalies are the most common type of organ malformation, affecting approximately 1% of all newborn infants. More than 90% of these children now survive into adulthood. They need to be cared for by specialists for adults with congenital heart disease (ACHD), as well as by family physicians, internists, and cardiologists who are adequately versed in the basic management of persons with this lifelong condition.

METHODS

This review is based on pertinent publications retrieved by a selective literature search, including guidelines and consensus statements from Germany and abroad.

RESULTS

Cardiovascular malformations cover a very wide spectrum, and the evidence base for the treatment of older patients with these conditions is scant. Congestive heart failure, arrhythmias, and the sequelae of pulmonary arterial hypertension are the main contributors to cardiac morbidity and mortality. Preg - nancy counseling, endocarditis prophylaxis, vaccinations, and psychosocial aspects must be targeted to each individual patient. Neither the affected patients nor their family physicians are yet adequately acquainted with the recently created care structures for this patient group.

CONCLUSION

The care of ACHD is a multidisciplinary task that requires basic care by primary care physicians as well as the involvement of specialized cardiologists in order to ensure optimal individualized treatment.

摘要

背景

先天性心脏畸形是最常见的器官畸形类型,影响约所有新生儿的 1%。现在,超过 90%的儿童存活到成年。他们需要由成人先天性心脏病 (ACHD) 专家以及充分了解此类终身疾病基本管理的家庭医生、内科医生和心脏病专家来照顾。

方法

本综述基于通过选择性文献搜索检索到的相关出版物,包括来自德国和国外的指南和共识声明。

结果

心血管畸形涵盖非常广泛的范围,对于这些疾病的老年患者的治疗证据基础很少。充血性心力衰竭、心律失常和肺动脉高压的后遗症是导致心脏发病率和死亡率的主要原因。妊娠咨询、心内膜炎预防、疫苗接种和社会心理方面必须针对每个个体患者。受影响的患者及其家庭医生都还没有充分了解最近为该患者群体创建的护理结构。

结论

ACHD 的护理是一项多学科任务,需要初级保健医生提供基本护理,并需要专门的心脏病专家参与,以确保进行最佳的个体化治疗。

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