Counseling adolescents with congenital heart disease

J Cardiovasc Nurs. 1992 Apr;6(3):65-73. doi: 10.1097/00005082-199204000-00007.


Adolescents with congenital heart disease need information regarding their cardiac condition and health care needs, including any life-style implications of the cardiac diagnosis. Pertinent topics to be addressed include preventive health care needs, physical activity (recreational and vocational considerations), pregnancy and contraception issues, and psychosocial stresses of adolescents. Sensitive counseling and health education by nurses can promote the physical health and psychosocial adaptation of adolescents with congenital heart disease.

PIP: Congenital heart disease impedes developmental tasks associated with adolescence. Thus nurses need to conduct sensitive counseling with adolescents with congenital heart disease. These adolescents see themselves as different and embrace attitudes and behaviors of peers even when some behaviors pose likely health risks. To gain control over their lives and be able to make decisions, they must be familiar with their cardiac condition and complete health care needs. They also view their physical condition as worse than medically indicated. Nurses should counsel each student about sports participation based on an individual basis. Adolescents who have undergone successful cardiac repair for ventricular septal defect, atrial septal defect secundum, endocardial cushion defect (incomplete), and patent ductus arteriosus can participate in competitive sports. Adolescents tend to fear sexual arousal because the heart rate and blood pressure increase. Yet they tend to be as sexually active as their healthy peers. Most people with mild, unoperated heart disease or successfully repaired defects are likely to have a normal pregnancy and a healthy infant. The IUD is contraindicated. Oral contraceptives (OCs) tend to be safe especially progestin-only OCs. Nurses should recommend barrier methods for conscientious users and sexual abstinence. The likelihood of a parent with congenital heart disease having a child with the same disease is higher than the general population, but it still is small. Genetic counseling must also include warnings about the effect of some cardiovascular medications on the developing fetus. Adolescents need vocational guidance to encourage them to pursue careers they want and steer them away from careers that are potentially harmful. Nurses should assess their feelings toward drugs and alcohol to help them choose not to use these substances. They should determine the quality of support systems available to adolescents with heart disease, recognize social concerns, and reinforce positive coping responses.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Contraception
  • Female
  • Heart Defects, Congenital / psychology*
  • Humans
  • Life Style
  • Male
  • Patient Education as Topic*
  • Physical Exertion
  • Pregnancy
  • Primary Prevention
  • Psychology, Adolescent*