Approach to ACHD

1. Approach to ACHD in Pediatrics
• Understanding the continuum of congenital
heart disease care
• Presented by: [Your Name / Institution]
• Date: [Date of Presentation]

2. Introduction
• - Definition of ACHD
• - Importance of lifelong care in CHD patients
• - Increasing prevalence due to improved
survival

3. Epidemiology
• - ~90% of children with CHD now survive into
adulthood
• - Estimated 1.4 million adults with CHD in the
US
• - Common defects: TOF, TGA, Fontan, etc.

4. Why Pediatricians Should Know
About ACHD
• - Early planning for transition
• - Coordination with cardiologists
• - Identifying red flags and complications early

5. Classification of CHD
• - Simple: ASD, VSD, PDA
• - Moderate: TOF, coarctation of aorta
• - Complex: Fontan circulation, single ventricle
physiology

6. Clinical Approach
• - Detailed history: surgery, interventions,
complications
• - Growth and development assessment
• - Cardiac exam and vitals
• - Functional capacity (NYHA class)
• - Screening for complications

7. Common Pediatric Concerns in
ACHD Patients
• - Cyanosis
• - Heart failure
• - Arrhythmias
• - Exercise intolerance
• - Pulmonary hypertension

8. Investigations
• - ECG
• - Echocardiography
• - Cardiac MRI/CT
• - Holter monitoring
• - Cardiac catheterization (if needed)

9. Transition of Care
• - Age-appropriate education
• - Gradual shift of responsibility
• - Transition clinics: joint care with ACHD
specialists

10. Psychosocial Aspects
• - Neurodevelopmental issues
• - Mental health (depression, anxiety)
• - School/work challenges
• - Family and peer support

11. Preventive Care
• - Endocarditis prophylaxis
• - Immunizations (e.g., influenza, RSV,
pneumococcus)
• - Reproductive counseling (adolescents)
• - Lifestyle modifications

12. Coordination with ACHD Team
• - Role of pediatric cardiologist
• - When to refer to adult CHD center
• - Multidisciplinary approach

13. Case Example (Optional)
• - Pediatric patient approaching transition
• - Highlight management and education points

14. Summary
• - ACHD begins in pediatrics
• - Identify risk, plan care, educate family
• - Support smooth transition to adult care

15. References
• - AHA/ACC Guidelines on ACHD
• - ESC Guidelines
• - Pediatric cardiology textbooks

16. Thank You
• Questions & Discussion