LAUSR

Congenital heart disease (CHD) results from disruption of the complex sequence of molecular and cellular events that lead to the development of the embryonic and fetal heart.1 CHD can be cyanotic or noncyanotic, depending on whether the disruption allows deoxygenated blood to bypass the lungs and enter the systemic circulation. Some forms of CHD are lethal shortly after birth without treatment, others may not be identified or cause problems until adulthood, and still, others may be noted incidentally at autopsy. Improved medical, interventional, and surgical techniques have greatly improved survival of patients harboring the more malignant forms and given birth to the undermanned American Board of Internal Medicine recognized specialty of adult congenital heart disease.2