Sustaining happiness in adult congenital heart disease.
Ari M. Cedars M.D.
Cedars, A. and A. R. Opotowsky (2016). “Sustaining happiness in adult congenital heart disease.” World J Pediatr Congenit Heart Surg 7(5): 635-637.
Patients with ACHD appear to have a distinct psychological adaptation to their lifelong heart disease. Although there is some inconsistency in the results of published studies, most data indicate that QOL among patients with ACHD is similar to the healthy general population, with the exception of the physical functioning domain.3 Furthermore, despite marked variability in objectively measured physical capacity between lesions,4 QOL in ACHD is not clearly related to lesion severity or complexity.3,5 This phenomenon appears to be consistent between countries with dramatically different health-care systems.6 The present study by Steele et al in a group of patients with CHD of high complexity provides further evidence for this observation. The apparent mental resilience among patients with ACHD is in stark contrast to adults with acquired heart failure (HF) in whom QOL is notably impaired compared to healthy controls.7 Although the reasons for preserved QOL in ACHD remain unknown, it has been proposed that patients with ACHD have a unique ‘‘sense of coherence.’’8 This concept, first introduced by Aaron Antonovsky as a metric of individual optimism and sense of control, may insulate patients with ACHD against health-related stressors.9