Definition and Diagnosis of Heart Failure in Adult Congenital Heart Disease

  • Craig S. BrobergEmail author
Part of the Congenital Heart Disease in Adolescents and Adults book series (CHDAA)


Despite the common appellation of heart failure (HF) in adults with congenital heart disease (ACHD), currently used definitions of this ubiquitous term are broad and inconsistent. At its core the term indicates an inability of the heart to meet the demands of the body, though this is both too non-specific and too limiting for practical use in the clinical setting. Instead, “heart failure” should designate individuals with a different risk profile or those needing a different management strategy. This chapter reviews currently used definitions, how they apply to HF-related ACHD, and common challenges in such application. Criteria used in published research range from strict imaging metrics to ill-defined clinical descriptors or billing codes. Such variety lends emphasis to the understanding that HF is not one event, but a progressive spectrum of change over a lifetime. To be most practical, HF defines an individual with clinical symptoms in the setting of myocardial dysfunction specifically. Yet especially in ACHD, it should also encompass manifestations of myocardial change before symptoms occur that may merit special management consideration. Applied definitions should also consider the specific type of ACHD, the dynamic nature of many variables used, and unique challenges when applying criteria in each subgroup.


Definition Diagnostic testing Ventricular dysfunction Myocardial fibrosis B-type natriuretic peptide 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Adult Congenital Heart Program, Knight Cardiovascular InstituteOregon Health and Sciences UniversityPortlandUSA

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