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Adult congenital heart disease with pulmonary arterial hypertension: mechanisms and management

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Abstract

Adult congenital heart disease (ACHD) encompasses a range of structural cardiac abnormalities present before birth attributable to abnormal foetal cardiac development. The pulmonary circulation of patients with ACHD and intracardiac or extracardiac defects is often exposed to increased blood flow and occasionally to systemic pressures. Depending on the location and magnitude of the defect as well as the time of surgical correction, the patient with ACHD is at risk of developing pulmonary arterial hypertension (PAH), which dramatically increases morbidity and mortality. It is encouraging that therapies applied in idiopathic PAH and significantly improve outcome are also effective in ACHD-related PAH (ACHD-PAH). This review summarizes the challenges encountered in the diagnosis and management of ACHD-PAH.

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  1. Department of Cardiology, Larissa University General Hospital, P.O. Box 1425, 411 10, Larissa, Greece

    Michail Papamichalis, Andrew Xanthopoulos, John Skoularigis & Filippos Triposkiadis

  2. Intensive Care Unit, General Hospital of Larissa, Larissa, Greece

    Panagiotis Papamichalis

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Papamichalis, M., Xanthopoulos, A., Papamichalis, P. et al. Adult congenital heart disease with pulmonary arterial hypertension: mechanisms and management. Heart Fail Rev 25, 773–794 (2020). https://doi.org/10.1007/s10741-019-09847-5

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