Dating, Disclosure, and Romantic Relationships Pose Challenges for Adults With Congenital Heart Disease: A Mixed-Methods Study

Background As survival into adulthood has improved, adults with congenital heart disease (CHD) increasingly face psychosocial challenges related to long-term living with their condition. Romantic relationships are a key source of social support, yet the impact of the condition on dating and romantic experiences remains poorly understood. Objectives To explore dating and romantic relationship experiences in adults with congenital heart disease (CHD), focusing on disclosure and communication, while describing patterns by sex and disease complexity and incorporating partner perspectives. Methods This national cross-sectional online survey included individuals aged ≥16 years with CHD. Dating- and relationship-related questionnaire items were analyzed using descriptive quantitative and inductive thematic qualitative analyses, including descriptive subgroup analyses by sex and disease complexity. Partner perspectives were included to provide relational context. Results Among 109 CHD patients (69% women, 54% aged 26-40 years, 87% with moderate to severe disease), 21% reported dating difficulties, 40% difficulties disclosing their condition to dates, and 14% relationship dissolution attributed to CHD. Relationship challenges mainly concerned family planning (27%) and limitations in shared activities (25%). Qualitative findings, supplemented by five partner perspectives (n=5), suggested fear of rejection during early disclosure and the importance of open communication. Descriptively, women and patients with moderate to severe disease reported more difficulties. Conclusions This mixed-methods study provides novel exploratory insight into the relational impact of CHD. Disclosure and communication appear particularly challenging during relationship establishment, whereas physical limitations contribute to challenges within established relationships. These findings support integrating relational support into routine CHD care.