Überraschende Echobefunde als Erstdiagnose eines angeborenen Herzfehlers im Erwachsenenalter

Zusammenfassung

Angeborene Herzfehler (AHF) werden teilweise erst im Erwachsenenalter diagnostiziert, entweder weil sie erst dann klinisch auffällig werden oder bei vorausgegangenen Untersuchungen übersehen wurden. Im Rahmen einer routinemäßigen transthorakalen Echokardiografie (TTE) können in der kardiologischen Praxis oder Klinik angeborene kardiale Anomalien leicht fehlgedeutet werden, da der Fokus in der Erwachsenenkardiologie überwiegend bei erworbenen Herzfehlern, einer Kardiomyopathie, Klappenerkrankungen oder einer systolischen oder diastolischen Dysfunktion liegt. Demgegenüber spielt eine thematische Auseinandersetzung mit AHF häufig eine nur untergeordnete Rolle, die Erwartungshaltung hinsichtlich angeborener kardialer Anomalien ist eher gering und die Sinne für mögliche AHF oft nicht geschärft. Dieser Artikel soll dazu beitragen, die Wahrscheinlichkeit des Erkennens eines AHF im Rahmen der TTE-Untersuchung zu erhöhen.

Abstract

Congenital heart defects (AHF) are sometimes not diagnosed until adulthood; either because they only become clinically apparent later in life or were overlooked until then. During routine transthoracic echocardiography (TTE) examination in the cardiology practice or clinic, cardiac abnormalities can be suspected and patients should be referred for further diagnosis to a center with AHF expertise. This requires knowledge of the echocardiographic presentation of AHF. Since the focus of adult cardiology is predominantly on acquired cardiac disease such as dilated or ischemic cardiomyopathy, valve dysfunction, or ventricular dysfunction, dealing with AHF often plays a minor role. Therefore, the expectation regarding congenital cardiac anomalies is not particularly high and the eye for possible – in clinical routine more frequent or rare – cardiac defects often not sharpened. This article presents the most common AHF and their echocardiographic findings to help increase the likelihood of detecting an AHF by TTE in clinical practice.

Schlüsselwörter

Erwachsene mit angeborenen Herzfehlern - EMAH - Erstdiagnose - TTE - angeborene Herzfehler - transthorakale Echokardiografie

Key words

adult congenital heart disease - ACHD - GUCH - first diagnosis - transthoracic echocardiography - congenital heart disease

^* geteilte Erstautorenschaft

^# geteilte Letztautorenschaft

Publication History

Article published online:
11 October 2021

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