Adult Congenital Heart Disease: Common Lesions, Symptoms, and When to Intervene

Congenital heart disease (CHD) is one of the most common birth defects worldwide, affecting nearly 1% of all live births.

Thanks to advances in pediatric cardiology and cardiac surgery, most children with congenital heart disease now survive into adulthood.

However, reaching adulthood does not mean the condition disappears. Many patients continue to live with what is termed Adult Congenital Heart Disease (ACHD)—a complex spectrum of heart defects that require lifelong follow-up, timely interventions, and expert care.

For adults living in Hyderabad and surrounding areas, finding the right specialist is critical. With two decades of experience and more than 20,000 successful procedures,Dr. Sai Ravi Shanker, a highly respected Interventional Cardiologist in Ameerpet, Hyderabad, provides world-class expertise in managing both simple and complex congenital heart diseases in adults.

What Is Adult Congenital Heart Disease (ACHD)?

Congenital heart disease refers to structural defects in the heart present from birth. While some defects are minor and cause no symptoms, others can be severe and life-threatening.

Adult Congenital Heart Disease (ACHD) occurs when individuals who were born with these conditions continue to live into adulthood, either with repaired hearts or residual lesions that need lifelong monitoring.

With advancements in medical care, more than 90% of children with CHD now survive to adulthood, creating a growing population of ACHD patients.

Many of them require periodic evaluation and timely intervention to prevent complications such as heart failure, arrhythmias, pulmonary hypertension, or stroke.

Common Congenital Heart Lesions Seen in Adults

1. Atrial Septal Defect (ASD)

  • A hole between the heart’s upper chambers (atria).
  • Small ASDs may remain undetected for years, while larger ones can lead to right heart enlargement, arrhythmias, or pulmonary hypertension.
  • Intervention: Transcatheter closure using a device is often performed by an experienced interventional cardiologist.

2. Ventricular Septal Defect (VSD)

  • A hole between the lower chambers (ventricles).
  • Small VSDs may close on their own, but larger defects can cause heart failure or increased lung pressures.
  • Intervention: Closure may be surgical or transcatheter, depending on the size and location.

3. Patent Ductus Arteriosus (PDA)

  • A persistent connection between the aorta and pulmonary artery.
  • Leads to volume overload of the heart and lungs.
  • Intervention: Device closure via catheter-based techniques.

4. Coarctation of the Aorta

  • Narrowing of the aorta, leading to high blood pressure in the upper body and weak circulation in the lower body.
  • Intervention: Balloon angioplasty with or without stent placement.

5. Tetralogy of Fallot (TOF)

  • A complex condition involving four heart defects.
  • Most patients undergo childhood surgery, but residual defects, arrhythmias, or pulmonary valve regurgitation often require attention in adulthood.

6. Ebstein’s Anomaly

  • A malformation of the tricuspid valve and right ventricle.
  • Can lead to cyanosis, arrhythmias, or heart failure in adults.

7. Transposition of the Great Arteries (TGA)

  • Surgically corrected in infancy, but adults may face complications such as arrhythmias, systemic right ventricular dysfunction, or baffle obstruction.

Symptoms of Adult Congenital Heart Disease

The presentation of ACHD can vary from being completely silent to producing severe, disabling symptoms. Common symptoms include:

  • Shortness of breath during activity or at rest
  • Persistent fatigue and reduced exercise capacity
  • Swelling in the legs, ankles, or abdomen
  • Palpitations or irregular heartbeats
  • Chest pain or discomfort
  • Fainting episodes (syncope)
  • Cyanosis (bluish discoloration of lips and skin)

Even if symptoms are mild, adults with congenital heart defects should not ignore them. Regular follow-up with a specialist ensures early detection of complications before they become life-threatening.

When Should Adults with Congenital Heart Disease Seek Intervention?

The timing of intervention in ACHD is crucial. Not all defects require immediate treatment, but ignoring them can lead to serious complications.

The decision depends on several factors such as the type of lesion, size of the defect, heart function, and symptoms.

Indications for Intervention Include:

  • Significant left-to-right shunt(e.g., large ASD, VSD, or PDA) causing chamber enlargement or pulmonary hypertension.
  • Symptomatic patients with breathlessness, fatigue, or recurrent chest infections.
  • Right heart overloador declining heart function.
  • Arrhythmias or heart failure related to congenital lesions.
  • Cyanosis or low oxygen levelsin complex lesions.
  • Residual or repaired defectsshowing progressive worsening over time.

Role of Interventional Cardiology in ACHD

Today, many congenital heart defects in adults can be corrected usingminimally invasive, catheter-based proceduresperformed in the cath lab, avoiding the need for open-heart surgery. Examples include:

  • Device closure for ASD, VSD, or PDA
  • Balloon angioplasty and stent placement for coarctation of the aorta
  • Percutaneous pulmonary valve implantation
  • Advanced imaging-guided interventions (IVUS/OCT) for precise repair

With over 20 years of experience,Dr. Sai Ravi Shanker, one of the Best Cardiologists in Ameerpet, Hyderabad, is known for his expertise in performing complex interventional procedures safely and effectively.

The Importance of Lifelong Follow-Up

Adult congenital heart disease is not a one-time issue. Even after successful surgery or intervention, patients need regular monitoring because:

  • New complications may develop with age.
  • Scar tissue or residual defects can trigger arrhythmias.
  • Heart function may gradually decline.
  • Prosthetic valves or devices require long-term surveillance.

Patients should undergo periodic imaging (echocardiography, cardiac MRI, or CT scans) and functional tests as recommended by their cardiologist.

Why Choose Dr. Sai Ravi Shanker for ACHD Care in Hyderabad?

When it comes to managing congenital heart disease in adults, expertise and experience matter the most. Dr. Sai Ravi Shanker stands out as a trusted Interventional Cardiologist in Ameerpet, Hyderabad, offering patient-centered care backed by advanced medical technology.

  • 20+ years of experience in interventional cardiology
  • Over 20,000 cath lab proceduresperformed successfully
  • Expertise inASD/PDA device closures, structural heart interventions, valve replacements, and complex coronary procedures
  • International recognition as Fellow of the American College of Cardiology (FACC) and the European Society of Cardiology (FESC)
  • Active leadership roles in the Cardiological Society of India.

Patients under his care benefit not only from clinical expertise but also from compassionate, personalized treatment plans.

Conclusion

Adult Congenital Heart Disease is a lifelong condition that requires continuous medical attention, timely interventions, and expert care. Common lesions like ASD, VSD, and PDA, as well as complex conditions such as Tetralogy of Fallot or Ebstein’s anomaly, can cause serious complications if neglected.

With advanced interventional cardiology, many of these conditions can be corrected or managed without open-heart surgery.

For patients and families in Hyderabad, consulting the Best Cardiologist in Ameerpet, Hyderabad, Dr. Sai Ravi Shanker, ensures world-class care, accurate diagnosis, and effective treatment strategies tailored to individual needs.

If you or your loved one has been diagnosed with congenital heart disease, it’s never too late to seek expert advice.

Early consultation and timely intervention can make all the difference in living a healthy, active life.

Book your appointment today with Dr. Sai Ravi Shanker at Aster Prime Hospitals, Ameerpet, Hyderabad, and take the first step towards better heart health.