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The changing epidemiology of congenital heart disease

Nature Reviews Cardiology volume 8, pages 50–60 (2011)Cite this article

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Abstract

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

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Figure 1: Distribution of age at death in adult patients with congenital heart disease in the Netherlands (2002–2007).
Figure 2: Number and percentage of adult patients in the Netherlands with congenital heart disease who had arrhythmias in 2007.

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Authors and Affiliations

  1. Department of Cardiology, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105, AZ, The Netherlands

    Teun van der Bom, A. Carla Zomer, Berto J. Bouma & Barbara J. M. Mulder

  2. Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105, AZ, The Netherlands

    Aeilko H. Zwinderman

  3. Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Folkert J. Meijboom

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  1. Teun van der Bom
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  2. A. Carla Zomer
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  3. Aeilko H. Zwinderman
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  4. Folkert J. Meijboom
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  5. Berto J. Bouma
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  6. Barbara J. M. Mulder
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Contributions

T. van der Bom and A. C. Zomer equally contributed to this manuscript. Both contributed to discussion of content for the article, researched data to include in the manuscript, reviewed and edited the manuscript before submission, and revised the manuscript in response to the peer-reviewers' comments. A. H. Zwinderman reviewed and edited the manuscript before submission. F. J. Meijboom, B. J. Bouma, and B. J. M. Mulder contributed to discussion of content for the article and reviewed and edited the manuscript before submission.

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Correspondence to Barbara J. M. Mulder.

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van der Bom, T., Zomer, A., Zwinderman, A. et al. The changing epidemiology of congenital heart disease. Nat Rev Cardiol 8, 50–60 (2011). https://doi.org/10.1038/nrcardio.2010.166

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