Adult Congenital Heart Disease a New Subspecialty

December 12, 2012

CHICAGO, Illinois — A new subspecialty of adult congenital heart disease is to be introduced by the American Board of Medical Specialties (ABMS); it will be available to internal and pediatric medicine cardiology trainees in the US within the next three years [1].

The new physician certification has been created in response to a growing need for cardiologists who are well versed in the field of adult congenital heart disease, as more and more children with this condition survive into adulthood.

The plight of young men and women born with congenital heart disease, who, only a generation or two ago, rarely made it to their 20s, was highlighted in a feature article on heartwire last year. Specialists in the field stress that, in most instances, this is a lifelong condition that is not "cured" by surgery in childhood but rather requires continuous follow-up, with further surgeries throughout life. And the number of adults living with congenital heart disease is now greater than the number of children who have it. But only about 10% of adult patients are seeking appropriate care from adult congenital cardiologists, and it is estimated that, at most, only 50% of those with adult congenital heart disease receive any sort of cardiovascular care.

Cardiology organizations have begun to recognize this issue, with the European Society of Cardiology issuing new guidelines for the management of grown-up congenital heart disease in 2010 [2] and the American Heart Association publishing a scientific statement on this topic last year [3].

One of the obstacles to proper treatment of these teenagers and young adults has been a lack of appropriately trained cardiologists specializing in this field. The move to introduce this new board certification will ensure there are enough doctors with the appropriate training to care for these individuals "in a consistent and comprehensive manner that is in compliance with recently published guidelines," says the ABMS.

The new subspecialty will be offered by the American Board of Internal Medicine (ABIM) and will create a pathway for certification for cardiologists previously certified by either the ABIM or the American Board of Pediatrics (ABP).

"The certification in the adult congenital heart disease subspecialty allows this growing group of patients to have their unique cardiac needs met and lifts some of the burden on pediatric cardiologists, who may not be appropriately trained in adult health issues,” observes ACC president Dr William Zoghbi in a statement [4].