Answer:

Congenital heart disease (CHD) refers to abnormalities in the heart muscle, valves, or chambers that develop during fetal growth. These conditions can alter normal blood flow through the heart valves, affecting heart development and function throughout life. While often diagnosed prenatally or shortly after birth, these abnormalities can sometimes be discovered only in adulthood. Therefore, adults can indeed have congenital heart disease. Many patients in their 60s or even 70s are diagnosed with ventricular septal defects, atrial septal defects, bicuspid aortic valves, aortic coarctation, Ebstein's anomaly, or mitral valve prolapse.

Some reasons for late diagnosis of congenital heart disease include:

Lack of prenatal fetal echocardiography

The fetal heart's structure, including chambers, valves, and blood vessels, largely completes formation by the 8th week of pregnancy. Doctors recommend fetal echocardiography between 18 and 24 weeks of gestation. Advanced fetal ultrasound techniques currently detect approximately 99% of congenital heart defects during pregnancy. Skipping this screening means defects may not be identified early for monitoring or intervention, either in utero or immediately after birth.

Newborns not screened for congenital defects

If prenatal fetal echocardiography is not performed, newborns should be screened for congenital heart disease immediately after birth. This allows for early detection and timely intervention, reducing risks and improving the child's health. Without this screening, existing congenital heart defects may persist into adulthood.

Disease without long-term symptoms

Many children with heart disease remain asymptomatic, undetected during pregnancy or after birth, until adulthood. Symptoms like pale or bluish skin, dizziness, fatigue, shortness of breath, and irregular heartbeats may then emerge. Without timely treatment, the condition risks serious complications such as cardiac arrhythmia, endocarditis, heart failure, pulmonary hypertension, stroke, and even death.

A doctor performs an atrial septal defect closure using an umbrella device on an elderly patient. *Photo: Tam Anh General Hospital*

Congenital heart disease has a genetic component. Since you were not screened after birth and have not had a specialized cardiac examination, you should seek an early check-up to determine if you have congenital heart disease. If diagnosed, prompt treatment is crucial to prevent the condition from silently progressing and causing dangerous complications.

Many effective treatment methods exist for adults with congenital heart disease. Mild defects may involve medication, lifestyle changes, and regular monitoring to prevent progression. For severe defects, doctors consider interventional procedures or surgery. Many patients over 40 years old who have undergone intervention for congenital heart disease report significant symptom improvement, leading normal lives with a life expectancy comparable to those without the condition.

Professor, Doctor Vo Thanh Nhan

Director of Interventional Cardiology Center

Tam Anh General Hospital, TP HCM