scholarly journals Adequacy of Cancer Screening in Adult Women with Congenital Heart Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Mitalee P. Christman ◽  
Margarita Castro-Zarraga ◽  
Doreen DeFaria Yeh ◽  
Richard R. Liberthson ◽  
Ami B. Bhatt
Keyword(s):  
Primary Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cancer Screening ◽  
Primary Care Physicians ◽  
Congenital Heart ◽  
Care Center ◽  
Adult Women ◽  
Cancer Society ◽  
Pap Tests

Adults with congenital heart disease (ACHD) face noncardiac healthcare challenges as the population ages. We assessed whether women with ACHD have comparable cancer screening rates to non-ACHD women in a cardiac practice and to the general population. We performed a retrospective review of 175 adult women seen in a cardiac care center in 2009–2011. Data on Pap tests, mammography, and colonoscopies, were collected through electronic medical records and primary care provider records. Adequate documentation was available for 100 individuals with ACHD and 40 comparator cardiac patients. The adequacy of screening was determined using guidelines set forth by the American Cancer Society in 2010. Compared with the national average, ACHD patients had significantly lower rates of Pap tests (60% versus 83%, ) and mammography (48% versus 72%, ). Compared with non-ACHD women in the same practice, ACHD patients had consistently lower rates of mammography (48% versus 81%, ) and colonoscopies (54% versus 82%, ). As the population of ACHD individuals ages, attention to cancer screening becomes increasingly important but may be overlooked in this population. Primary care physicians and cardiologists should collaborate to ensure appropriate cancer screening for this growing population.

scholarly journals Facts about the General Medical Care of Adults with Congenital Heart Defects: Experience of a Tertiary Care Center

2020 ◽  
Vol 9 (6) ◽  
pp. 1943
Author(s):  
Lavinia Seidel ◽  
Kathrin Nebel ◽  
Stephan Achenbach ◽  
Ulrike Bauer ◽  
Peter Ewert ◽  
...  
Keyword(s):  
Heart Disease ◽  
Medical Care ◽  
Primary Care Physicians ◽  
Congenital Heart ◽  
Heart Defects ◽  
Care Center ◽  
Tertiary Care ◽  
Care Practice ◽  
Cross Sectional ◽  
Almost All

Background: Due to the increase in survival rates for congenital heart disease (CHD) in the last decades, over 90% of patients today reach adulthood. Currently, there are more than 300,000 adults with CHD (ACHD) living in Germany. They have an increased need for specialized medical care, since almost all ACHD have chronic heart disease and suffer from specific chronic symptoms, risks, and sequelae. Primary care physicians (PCPs) play a crucial role in referring patients to ACHD specialists or specialized institutions. This cross-sectional study is intended to clarify the real-world care of ACHD from the PCP’s perspective. Methods: This analysis, initiated by the German Heart Centre Munich, was based on a 27-item questionnaire on actual ACHD health care practice in Germany from the PCP’s perspective. Results: In total, 767 questionnaires were considered valid for inclusion. The majority of the PCPs were general practitioners (95.9%), and 84.1% had cared for ACHD during the past year. A majority (69.2%) of the PCPs had cared for patients with simple CHD, while 50.6% and 33.4% had cared for patients with moderate and severe CHD, respectively, in all age groups. PCPs treated almost all typical residual symptoms and sequelae, and advised patients regarding difficult questions, including exercise capacity, pregnancy, genetics, and insurance matters. However, 33.8% of the PCPs did not even know about the existence of certified ACHD specialists or centers. Only 23.9% involved an ACHD-specialized physician in their treatment. In cases of severe cardiac issues, 70.8% of the PCPs referred patients to ACHD-certified centers. Although 52.5% of the PCPs were not sufficiently informed about existing structures, 64.2% rated the current care situation as either “very good” or “good”. Only 26.3% (n = 190) of the responding physicians were aware of patient organizations for ACHD. Conclusions: The present study showed that the majority of PCPs are not informed about the ACHD care structures available in Germany. The need for specialized ACHD follow-up care is largely underestimated, with an urgent need for optimization to reduce morbidity and mortality. For the future, solutions must be developed to integrate PCPs more intensively into the ACHD care network.

Understanding the Fontan Procedure in Congenital Heart Disease Patients and the Importance of Early Hepatology Referrals: A Case Study

2018 ◽  
Vol 11 (2) ◽  
pp. 95-99
Author(s):  
Alice Chan
Keyword(s):  
Primary Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nurse Practitioners ◽  
Congenital Heart ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fontan Procedure ◽  
Early Screening

Background: Patients with congenital heart disease are surviving into adulthood because of new surgeries developed over the recent decades. One surgery is the Fontan procedure, which is used in patients with only one functioning ventricle. Although it has been saving lives, in the recent years multiple complications have been noted. Objective: To discuss the Fontan procedure and inform nurse practitioners in the primary care setting the importance of early screening and referral because of increasing number of liver complications in these patients. This case study highlights the dilemmas a patient with the Fontan procedure faces as a young adult. Methods: Evidence-based articles from the PubMed and Embase databases were used to support the case study. Results: Patients with the low-pressure Fontan circulation are under chronic passive congestion and have known liver complications such as liver fibrosis, cirrhosis, and protein-losing enteropathy. This can lead to a high-risk dual organ heart–liver transplant. Conclusions: Early screening and referral to a hepatologist are critical in these patients. Implications for Nursing: Since patients with congenital heart disease often present to the primary care setting, nurse practitioners in this area should understand the Fontan procedure and its associated complications so they can effectively manage these patients.

Outcome of children referred with heart murmurs referred from general practice to a paediatrician with expertise in cardiology

2014 ◽  
Vol 25 (1) ◽  
pp. 123-127 ◽  
Author(s):  
Abha Khushu ◽  
Anthony W. Kelsall ◽  
Juliet A. Usher-Smith
Keyword(s):  
Primary Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Family History ◽  
General Practitioners ◽  
Congenital Heart ◽  
Hospital Records ◽  
Heart Murmurs ◽  
History Of ◽  
Referral Practice

AbstractBackgroundHeart murmurs are common in children. The majority are detected incidentally, and congenital heart disease is rare. There are no published United Kingdom guidelines for management of children with murmurs in primary care. Common practice is to refer all children for specialist assessment.AimTo review outcomes of children with heart murmurs who were referred by general practitioners to a clinic conducted by a paediatrician with expertise in cardiology.Design and settingA retrospective review of children referred by general practitioners to a paediatrician with expertise in cardiology.MethodsHospital records of all children under 17 years of age who attended the clinic during 2011 were reviewed. We excluded children previously seen by any cardiology service.ResultsThere were 313 new primary care referrals, with complete records available for 310 children. Of them, 186 (60%) were referred with a murmur: 154 for an asymptomatic murmur alone, and 32 for a murmur plus additional symptoms or family history of congenital heart disease. All underwent echocardiography. Of the patients, 38 (20%) had congenital heart disease. Younger children were more likely to have congenital heart disease. There was no difference between rates of congenital heart disease in children with or without symptoms or a family history.ConclusionThe finding that a large proportion of children referred by general practitioners with asymptomatic heart murmurs have congenital heart disease supports current referral practice on clinical grounds.

scholarly journals Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034588
Author(s):  
Serena Francesca Flocco ◽  
Rosario Caruso ◽  
Serena Barello ◽  
Tiziana Nania ◽  
Silvio Simeone ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Congenital Heart ◽  
Phenomenological Analysis ◽  
Adult Women ◽  
Early Motherhood ◽  
Italian Women ◽  
Experiences Of Women

ObjectiveThis study explored the lived experiences of women with congenital heart disease (CHD) during pregnancy and early motherhood.DesignQualitative study using semistructured interviews. Data were analysed according to interpretative phenomenological analysis.SettingSan Donato Milanese, Italy.Participants12 adult women during pregnancy or early motherhood.ResultsThree main themes emerged from the analysis that were labelled as follows: ‘Being a woman with CHD’; ‘Being a mother with CHD’; and ‘Don’t be alone’. Mothers described both positive and negative feelings about their pregnancies and transitions from childless women to mothers with CHD. They needed supportive care to improve the management of their health during pregnancy and early motherhood.ConclusionThis study explored the lived experiences of women with CHD during pregnancy and early motherhood. The emerged themes represent an initial framework for implementing theory-grounded educational and supportive strategies that improve self-care, engagement and quality of life for women with CHD. Furthermore, the study’s results provide guidance for operationalising the described experiences into items and domains for future cross-national surveys.

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