Most Prevalent Defects in Adult Populations
Among adults with congenital heart disease, the most common diagnoses include bicuspid aortic valve — which affects approximately 1–2% of the general population and is associated with progressive valve disease and aortic dilation over time — followed by atrial septal defects (including secundum ASD, which is often detected in adulthood when symptoms of right heart volume overload or atrial arrhythmia develop), and ventricular septal defects that were small and hemodynamically insignificant in childhood and were never repaired. Adults who underwent repair of complex defects such as tetralogy of Fallot, transposition of the great arteries, or pulmonary atresia in childhood are now an increasingly large segment of the ACHD population as survival has improved.
Why the Spectrum Differs From Children
The distribution of congenital heart defects in adult versus pediatric populations differs substantially because access to early surgical intervention, survival rates, and the natural history of specific lesions all influence who reaches adulthood with a given diagnosis. Defects associated with high surgical mortality in prior decades are now represented in adult populations at increasing rates due to surgical advances. Additionally, some defects — such as bicuspid aortic valve, secundum ASD, and partial anomalous pulmonary venous return — are commonly identified for the first time in adulthood during evaluation for a murmur, arrhythmia, or incidental echocardiographic finding. An ACHD cardiologist is best positioned to evaluate and manage these findings in the context of lifetime cardiac risk.
Reviewed by Dr. Pradeepkumar Charla, MD, MBA, FAAP, FACC
Pediatric & Adult Congenital Cardiologist — Congenital Heart Compass Medical PLLC
Last reviewed:
Medical disclaimer: This content is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Always consult a qualified cardiologist for decisions about your congenital heart disease care.