New Guideline on Managing Congenital Heart Disease in Adults
The American Heart Association and the American College of Cardiology (ACC), along with several other leading medical associations, have issued a new guideline for managing congenital heart disease in adults.
The new guideline provides updated recommendations for monitoring, counseling and treating adults with congenital heart disease. It includes evidence from research published between 2017-2024 and replaces the previous guidance issued in 2018.
It includes additions related to the role of clinicians with specialized expertise in guiding the care of adults with congenital heart disease; updates regarding mental health, physical activity, pregnancy and heart failure; and new recommendations about specific types of heart defects and treatment approaches.
Top Takeaways for Patients in the 2025 Guideline for Managing CHD in Adults
- Adults with congenital heart disease (ACHD) have better health outcomes when they receive care at an ACHD center(link opens in new window). ACHD will face different challenges than kids with the same condition and need to take care of their health in different ways. If accessing an ACHD center is difficult, talk with your clinician about what can help you get connected to this type of clinical care. They may know about resources that can help you.
- It’s important to help teens transition to ACHD treatment centers. The typical age to begin planning transition to this type of care is around 12-16 years old. The transfer of care is often done between ages 18 and 21. Routine check-ups are very important. Unfortunately, as many individuals transition out of pediatric care, they may struggle to connect with health centers for adults with a CHD. Find more information on this important transition here.
- Individuals with ACHD need to meet with a team of different medical specialists called a multidisciplinary team to help with complex decision making. This is particularly important for individuals with complex heart problems who may need special guidance to make treatment decisions. Learn about some of the health professionals who may make up an ACHD multidisciplinary care team here (PDF).
- It’s important to consult with an ACHD cardiologist before undergoing any procedures and surgeries – whether related to their heart or not. Particularly if they have a moderate or complex CHD. Their cardiologist can help them understand any risks to their heart and decide on the best care plan.
- It’s important to talk about reproductive health with the care team.
- Individuals with ACHD who can become pregnant should talk with their ACHD cardiologist to understand the best and safest birth control options, genetic testing, how a pregnancy could affect their health, and safe birthing options. The majority of pregnant patients with ACHD can undergo vaginal delivery safely.
- Men with ACHD may also discuss their reproductive health with their care team, including whether genetic testing is appropriate for them.
- In patients with complex ACHD and atrial arrhythmias, rhythm control is generally preferred over rate control due to their unique anatomy and potential intolerance of rapid heart rates.
- There are new ways for when and how to help patients with both ACHD and heart failure. Talking with the care team to understand when and how this could change the care plan is important.
- There are also new ways to help individuals with Fontan physiology. People with Fontan circulation need to get checked every year with scans and blood tests to keep track of their heart and liver health. They should also see a liver doctor, called a hepatologist, because they might be at risk for a condition called Fontan-associated liver disease (FALD).
- Assessment of mental health needs for patients with ACHD is important. Mental health support is an important part of overall care. It’s a good idea to regularly check for signs of depression, anxiety, PTSD(link opens in new window), and thinking or memory problems. There are safe and effective treatments to help.
Important Links
