Most Common Cardiac Anomaly in Adults
The most common congenital heart defect found in adults is bicuspid aortic valve, followed by atrial septal defect (ASD). 1
Prevalence of Common Congenital Heart Defects in Adults
- Bicuspid aortic valve is the most common congenital heart anomaly in adults, followed by atrial septal defect 1
- Secundum ASD is one of the most commonly diagnosed congenital heart defects among adults and represents the most common type of ASD (60-70% of all cases) 1, 2, 3
- Ventricular septal defect (VSD) is the most common congenital heart defect at birth but many close spontaneously during childhood 4
- Other common congenital heart defects that survive into adulthood include mitral valve prolapse, aortic coarctation, pulmonary valve stenosis, patent ductus arteriosus, and tetralogy of Fallot 1
Atrial Septal Defect in Adults
- ASDs often go undetected in childhood and may not become symptomatic until the third or fourth decade of life 2, 5
- Approximately 75% of adults with ASD will eventually develop symptoms 6
- Common symptoms in adults with ASD include fatigue, dyspnea on exertion, and palpitations 6
- Adult comorbidities such as ischemic heart disease, hypertension, or diabetes can increase left-to-right shunting through an ASD, leading to pulmonary overcirculation 1
- Any adult presenting with atrial arrhythmia and a dilated right ventricle should be investigated for an atrial level shunt lesion 1
Ventricular Septal Defect in Adults
- VSD is the most common congenital heart defect at birth but has a high rate of spontaneous closure during childhood 4
- Adults with unrepaired VSDs may present with asymptomatic murmur, infective endocarditis, aortic regurgitation due to valve prolapse, or cyanosis and exercise intolerance from pulmonary vascular disease 4
- Perimembranous VSDs (Type 2) are the most common type, accounting for approximately 80% of all VSDs 4
Diagnostic Evaluation
- Echocardiography is the diagnostic test of choice for congenital heart defects in adults 1
- Initial workup usually includes posterior-anterior and lateral chest radiographs 1
- ECG may show characteristic findings depending on the specific defect 1
- MRI and CT are increasingly being used for evaluation of congenital heart disease in adults 1
Clinical Implications
- Adults with congenital heart disease require periodic imaging for monitoring their condition 1
- Approximately 10% of patients with common congenital heart defects survive undetected until adulthood 1
- The risk of developing pulmonary vascular disease increases with age in untreated atrial septal defects, particularly in females 5
- Life expectancy is reduced in adults with untreated ASDs, with almost 90% dying by age 60 7
Therefore, based on the available evidence, the answer to the question is (a) atrial septal defect, as it is the most common cardiac anomaly found in adults after bicuspid aortic valve, which was not listed as an option.