Department of Pediatrics and Internal Medicine (Cardiology), Yale University School of Medicine, New Haven, Connecticut, USA.
Curr Opin Pediatr. 2023 Oct 1;35(5):553-560. doi: 10.1097/MOP.0000000000001281. Epub 2023 Aug 8.
On top of existing rites of passage, adolescents with congenital heart disease (CHD) face additional challenges as related to their underlying medical condition. These include compliance with medications and appointments, establishing heart-healthy behaviors, navigating potential at-risk situations, and transition to adult-oriented care.
Teenagers with CHD should focus on the importance of exercise as this seems to have important long-term benefits and may help improve weight management. Mental health concerns are a major issue for teens with CHD and awareness and appropriate screening are critical. Discussion regarding sexual health, contraception, pregnancy, and CHD risk in offspring occur rarely in clinical practice, and their absence sets up the CHD adolescent for potential complications. Establishing patterns of trust and communication between physicians and teenage CHD patients are critical to enable the appropriate transition of care to adult congenital care, yet gaps in transition remain common.
The outpatient cardiologist has a critical role to help the teenager with CHD navigate difficult terrain. Returning to the roots of careful history taking, motivational interviewing, and open-ended questions may be of great benefit in warding off complications and helping steer the adolescent with CHD towards a life as a successful adult living with CHD.
除了现有的成年礼，患有先天性心脏病 (CHD) 的青少年还面临着与潜在医疗状况相关的额外挑战。这些挑战包括遵医嘱和定期就诊、建立健康的心脏行为、应对潜在的高危情况，以及向成人医疗过渡。
患有 CHD 的青少年应该重视运动的重要性，因为运动似乎有重要的长期益处，并可能有助于改善体重管理。青少年 CHD 患者的心理健康问题是一个主要问题，提高认识和进行适当的筛查至关重要。在临床实践中，很少讨论青少年的性健康、避孕、怀孕和 CHD 对后代的风险，这种缺失可能会导致 CHD 青少年出现潜在的并发症。在青少年 CHD 患者和医生之间建立信任和沟通模式对于实现向成人先天性心脏病护理的适当过渡至关重要，但过渡仍存在差距。
门诊心脏病专家在帮助 CHD 青少年应对困难方面发挥着关键作用。回归仔细的病史采集、动机访谈和开放式问题的根源可能会极大地有助于避免并发症，并帮助 CHD 青少年朝着成功的成年 CHD 患者的生活方向发展。
