Cardiac Neurodevelopment for Medical Professionals
Medical professionals play a critical role in ensuring that people with CHDs receive the neurodevelopmental care they require. In order to serve their patients, all clinicians should understand who is at risk of neurodevelopmental delay or disability, how to monitor for problems, and how to refer patients to necessary interventions and treatments.
This page is intended to give medical professionals the knowledge and resources they need to incorporate neurodevelopment into their existing practice.
Resources Spotlight
Bridging CHD Diagnosis to Neurodevelopmental Care
Patients with complex CHDs face neurodevelopmental risks in addition to their physical risks. Some patients show obvious signs of developmental impairment, such as an intellectual disability (ID) or partial paralysis. These patients clearly require services to meet their significant needs.
Other patients, however, have subtler neurodevelopmental concerns and may appear to be doing very well. In many cases, doctors can serve as the bridge to get these patients to necessary developmental care.
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The connection between CHDs and neurodevelopment
Young people with CHDs are often exposed to multiple interacting and cumulative risk factors that can profoundly influence their neurodevelopment. While all patients with a CHD are at elevated risk for neurodevelopmental delay or disability, certain medical, psychosocial, and growth factors can increase this risk, especially if they occur together.
For example, patients with CHDs are at higher risk if they have a medical history of genetic abnormality, extended or acute hypoxia, preterm birth, perioperative stroke or seizure, cardiopulmonary resuscitation, heart transplant, mechanical cardiac support, or brain injury. Psychosocial risk factors include living in poverty and parental psychological distress, and growth risk factors include feeding delay and failure to thrive.
By building awareness of patients' relative risk for neurodevelopmental delay or disability, medical providers can screen for and identify problems early, when interventions are most likely to be effective.
These questions and screeners can help medical professionals to identify neurodevelopmental concerns early and accurately:
Applying the AHA Scientific Statement to your practice
Understanding the recommended role of medical providers
In 2012, the American Heart Association released a Scientific Statement describing recommended practices for the evaluation and management of patients with CHDs. This statement was updated in 2024 to reflect the newest research.
The Statement assists medical professionals in determining the relative risk of patients, and makes recommendations for care based on this determination. By following these guidelines, medical professionals can provide patients with the care they need to thrive.
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Neurodevelopmental Risk Categories
Whether you are running a cardiac neurodevelopmental followup program or simply working to integrate AHA recommendations into your practice, understanding risk stratification is an important part of the process.
This article breaks down the risk categories as presented within the 2024 Sood et al Scientific Statement.
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Neuroprotective Strategies
Medical providers and other professionals can take concrete steps to reduce the neurodevelopmental risk of patients with CHDs. This article summarizes the neuroprotective strategies outlined in Sood et al's 2024 Scientific Statement.
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CND Surveillance, Screening, and Evaluation
Sood et al's 2024 Scientific Statement describes a differentiated approach to neurodevelopmental monitoring and assessment depending on a process of risk stratification. By following the described practices, medical professionals can increase the early and accurate identification of.neurodevelopmental delays and disabilities, and target resources efficiently.
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Managing Neurodevelopmental Delays and Disorders
Better and earlier identification of cardiac neurodevelopmental delays and disabilities benefits patients through access to appropriate treatments and interventions. This article describes best practices in managing neurodevelopmental delays or disabilities, as described by Sood et al (2024).
Help connect families to care
Neurodevelopmental care is usually best when it is local. An increasing number of hospitals in the United States and around the world are offering cardiac neurodevelopmental followup programs. If your facility does not have its own program, explore the map below to identify programs that are accessible to your patients.
If there are no programs nearby, maybe you can help found a program, and be the change your community needs.
Connecting Patients to Services
the right intervention for the right person at the right time
Patients often rely on their trusted physicians and nurses in order to find neurodevelopmental interventions. When medical providers understand the purpose and availability of evidence-based interventions, they are better able to get patients the help they need.
The interventions described below are appropriate for many young people with CHDs, and can help to remediate the most common associated neurodevelopmental concerns. You can find more interventions by exploring our resources.