Adults with complex congenital heart disease, particularly those with cyanotic lesions, face a significantly increased risk of stroke and cognitive impairment compared to the general population.
Adults with complex congenital heart disease face elevated risks of cerebrovascular events, necessitating awareness and targeted stroke prevention strategies by neurologists.
As infant and childhood mortality has decreased in congenital heart disease, this population is increasingly reaching adulthood. Adults with congenital heart disease (ACHD) represent a group with increased risk of stroke, silent brain infarcts, and vascular cognitive impairment. Cyanotic and other complex cardiac lesions confer the greatest risk of these cerebrovascular insults. ACHD patients, in addition to having an increased risk of stroke from structural cardiac issues and associated physiological changes, may have an accelerated burden of conventional vascular risk factors, including hypertension and impaired glucose metabolism. Adult neurologists should be aware of the risks of clinically evident and subclinical cerebrovascular disease in this population. We review the existing evidence on primary and secondary stroke prevention in individuals with complex congenital heart disease, and identify knowledge gaps in need of further research, including treatment of acute stroke in this population. Multisystemic genetic syndromes are outside the scope of this review.
Smith et al. (Thu,) conducted a review in Complex Congenital Heart Disease. Complex Congenital Heart Disease vs. General population was evaluated. Adults with complex congenital heart disease, particularly those with cyanotic lesions, face a significantly increased risk of stroke and cognitive impairment compared to the general population.
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