Adolescent Health | Mount Sinai Today

Ditch the Itch: Avoiding Skin Reactions to Halloween Costumes and Make Up

Sep 30, 2024 | Adolescent Health, Your Health

Halloween treats, costumes, and decorations are exciting for parents and children alike, but these holiday staples may be associated with unpleasant reactions, such as contact dermatitis or urticaria (hives).

As Halloween approaches and you are choosing your child’s costume, here are some helpful tips from Justine Fenner, MD, Assistant Professor of Dermatology at the Icahn School of Medicine at Mount Sinai, on how to protect your child’s skin.

Know the signs of a reaction

Justine Fenner, MD

Your child may be experiencing an adverse skin reaction if redness, itching, dryness, or blistering of the skin develops. If you notice these signs, immediately wash off any make-up/body paint and remove their costume and accessories. For some children, the rash may improve with removal of the offending agent, but others may require topical corticosteroids or oral antihistamines.

It is important to note that not all reactions develop equally. Conditions such as contact urticaria are more likely to develop immediately following an exposure. Irritant contact dermatitis may develop after a couple of hours or days, and allergic contact dermatitis may not be seen until two to three days following exposure.

Continue to watch for skin reactions even in the days following Halloween. Keep an eye on any reactions, and contact your doctor if your child isn’t improving with at-home treatments.

Do a spot check before applying face paint and makeup

Face paint and make-ups may contain preservatives such as methylchloroisothiazolinone/methylisothiazolinone, dyes, or fragrances that can be irritating to the skin. Be sure to test the face paint or makeup on a small area of your child’s skin, such as a spot on the inner wrist, for at least a week prior to full application on Halloween, to make sure your child does not develop a reaction.

Avoid false eyelashes and nails

Fake eyelashes are held in place with glues, and acrylic nails contain potential contact allergens such as cyanoacrylates, latex, and formaldehyde. Furthermore, these products may damage your child’s nails and eyelashes over time.

Beware of hidden nickel

Costume jewelry and accessories, such as belts, can also cause skin reactions as they commonly contain metals such as nickel, which is one of the most common causes of allergic contact dermatitis.

Opt for a natural, breathable fabric

When choosing a costume for your child, 100 percent cotton fabric is recommended. Other materials, such as wool and polyester, may be irritating to the skin. Irritation is especially likely if your child has a history of sensitive skin or eczema. Looser fitting, breathable fabrics also decrease the incidence of skin issues.

Most importantly, have fun and Happy Halloween!

Learn more about Pediatric Dermatology at Mount Sinai

New Funding Ensures Expansion of Mount Sinai Public Health and Racial Justice Program With New Partnership

Updated on Mar 23, 2023 | Adolescent Health, Featured

A new partnership between Mount Sinai’s Department of Health Education and The Blavatnik Family Women’s Health Institute has received funding from the Helen Gurley Brown Foundation to significantly expand the Public Health and Racial Justice Program. One of many robust youth education and empowerment offerings at Mount Sinai, the Public Health and Racial Justice Program seeks to cultivate the next cadre of young female scientists, community advocates, and health care workers from under-represented racial and ethnic groups, engaging girls of color, ages 16-18 years.

Alyssa Gale, MPH, Director of the Department of Health Education, explained how the program was created.

Alyssa Gale, MPH

“The Department of Health Education developed the Public Health and Racial Justice Program in the spring of 2020, in direct response to the parallel crises of the COVID-19 pandemic and state-sanctioned violence against people of color, both of which served as critical issues illuminating racism’s impact on public health,” she says. “We understood that young people were aware of and engaging in the discourse around racism and public health, and we wanted to provide a safe space in which they could learn about these issues and, more importantly, learn about how to get involved.”

Through a six-week summer program, participants are provided with an affirming and empowering space in which they can learn about the expansive field of public health and medicine through a racial justice lens, safely dialogue about challenging topics, and build skills and confidence around critical analysis, civic engagement, creative expression, and emotional processing. Senior researchers from the Blavatnik Institute and guest speakers from city agencies, community-based organizations, and across the Mount Sinai Health System provide mentorship and introduce participants to various areas of study and work.

Lajeanna Haughton, LMSW

Lajeanna Haughton, LMSW, Health Educator, has been facilitating this program since its inception and spoke about the importance of making the connection between learning and action. “I am so excited about and proud of our expansion. By introducing our participants to an even broader range of topics, community partners, and health system colleagues, we are hoping to expose our young people to a range of individuals, organizations, and movements who are working to address inequities, who reflect the communities our girls come from, and who can speak to the many different paths that can be taken in this work.”

The new partnership between the Department of Health Education and the Blavatnik Institute draws on the resources and strengths of both institutions, with a continued focus on seeking to address inequities in community health by cultivating a deep interest in science, medicine, and civic engagement among underrepresented youth.

Katharine McCarthy, PhD, MPH

The research team at the Blavatnik Institute, led by Leslee Shaw, PhD, the Institute’s Director, seeks to transform women’s health through discovering unique biological differences affecting women across their life span and devising pathways aimed to rectify racial and ethnic inequity for all women. Katharine McCarthy, PhD, MPH, an Assistant Professor in the Blavatnik Institute spoke about how this internal collaboration came about in the interest of better serving the community. “The underrepresentation of medical researchers and practitioners from backgrounds most affected by health disparities contributes to persistent health inequalities among women of color,” she says. “A diverse public health workforce that prioritizes community engagement is essential to translate research findings into effective interventions with a meaningful scientific and public health impact.”

Participants from previous cohorts of the Public Health and Racial Justice Program have shared the impact of their participation.

“The most meaningful thing about participating in the program is understanding the importance of youth activists and advocates. I was able to learn many new ideas from my peers and unlearn bias and stereotypes from other people’s experiences,” said one participant in the public health program. “Every moment of this program shaped my mind in the best way possible, and I am now able to identify the flaws in my community and the system through a reproductive and racial justice lens. This program is definitely something that I will take along with me in life forever and I hope to make a difference and impact many lives in the same way.”

“This program literally made me change my perspective on the issues I see,” added another. “Once you really analyze problems Black, queer, pregnant, low-income, etc. people face, it all leads back to some form of racism/oppression. And I am very grateful to have learned about these issues from this program. The discussions we had were so insightful…It was probably one of the most fulfilling experiences of my summer.”

Meet Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health at Mount Sinai

Updated on Mar 21, 2023 | Adolescent Health, AIGH, Featured

“I never wanted to be in a lab or doing statistics, but I absolutely love asking questions about how to best provide care for kids.” – Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health.

Rachel Vreeman, MD, MS, is Chair of the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai and the Director of the Arnhold Institute for Global Health. A pediatrician and researcher, she also continues her research work around HIV, with a focus on East Africa, as well as other global work related to children and adolescents living with HIV.

In addition, Dr. Vreeman chairs the Global Pediatric Working Group for the International Epidemiologic Databases Evaluating AIDS (IeDeA) consortium, a global consortium of HIV care programs funded by the National Institutes of Health that compiles data for more than two million people living with HIV.

Prior to joining Mount Sinai in 2019, she served as Director of Research for the Indiana University Center for Global Health and for the AMPATH Research Network, and was an Associate Professor of Pediatrics at the Indiana University School of Medicine and the Joe and Sarah Ellen Mamlin Scholar for Global Health Research. She received her bachelor’s degree from Cornell University where she majored in English literature. She has a master’s degree in clinical research from Indiana University School of Medicine and a medical degree from Michigan State University College of Human Medicine.

In this Q&A, Dr. Vreeman, who is also a best-selling author of books that debunk medical myths, discusses her vision for the Arnhold Institute for Global Health, how she has witnessed the transformation of care for children with HIV, and what it takes to be a good doctor and researcher.

Can you tell us a little bit about yourself and your background?

I am a pediatrician and researcher who specializes in trying to figure out how to improve care for children and adolescents growing up with HIV all around the world. I have worked for almost the last 20 years in a partnership in Kenya, growing a health care system for families with HIV and engaging with Kenyan partners around how we can best treat HIV in places like East Africa. I grew up in Michigan, then went to college at Cornell, medical school at Michigan State University, and trained in pediatrics at Indiana University. At Indiana University, I was introduced to global health through a long-standing partnership called the Academic Model Providing Access to Healthcare in Kenya, a 30-plus-year partnership between North American medical schools and a medical school and hospital system in western Kenya. I started spending about six months of the year living and working in Kenya, focused on the care of children with HIV.

One of the things that many people in global health don’t know about me is that I’ve co-authored three best-selling books that debunk medical myths people tend to hold about their bodies and health. This myth-busting has given me lots of interesting opportunities to talk about science and health; it has been featured in The New York Times, USA Today, The Los Angeles Times, Newsweek, and many other publications and on various television and radio shows such as Good Morning America and CNN.

A pediatrician and researcher, Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health, is also a best selling author. Here three books she co-authored:

Don’t Swallow Your Gum: Myths, Half-Truths, and Outright Lies about your Body and Health
Don’t Cross Your Eyes…They’ll Get Stuck Like That! And 75 Other Health Myths Debunked
Don’t Put THAT in THERE! And 69 Other Sex Myths Debunked

What is your vision for the Institute?

My vision for the Institute is that we would grow and deepen a small set of global health partnerships that radically improve the health systems in the places where we are partnering—and that these partnerships would model equity, sustainability, mutual trust, and mutual benefits. Through these kinds of partnerships, I believe the Arnhold Institute for Global Health will be able to move forward research, health care delivery, and educational opportunities that transform health care systems for vulnerable populations. Right now, we are growing these partnerships in Kenya, Nepal, Ghana, and New York City, and we are starting to see the first glimpses of how these partnerships can meet the health needs of populations such as adolescents living with HIV, neighborhoods with diverse populations struggling through COVID-19 spikes, pregnant people with unacceptably high rates of deaths and complications, and people seeking care for chronic diseases like hypertension in rural communities. I cannot wait to see our work like this continue to grow through the partnerships we have formed with academic medical centers, health systems, and government public health partners.

Nima Lama, left, Minister of Health for Bagmati Province in Nepal, presents Dr. Vreeman with a Nepali gift.

How did you get into the adolescent health field?

The most incredible privilege of my career has been the opportunity to become a pediatrician who can focus on supporting adolescents and young adults globally, including those who are living with HIV. In the early years that I worked in Kenya, our hospital wards and our clinics were full of young children who were dying from HIV. Two-year-olds, 3-year-olds, 4-year-olds. I did not take care of more than a handful of older kids. None of the kids born with HIV lived that long.

And now, our clinics in Kenya are such very different places. They are full of teenagers doing teenager things. Going to school, struggling through becoming adults, making friends and arguing with friends. All the good stuff and all the hard stuff. And HIV is now a chronic disease that they are living with. I love getting to watch youth transform not only their own stories, but also start to transform our world. It is the most inspiring, hope-bringing, sometime scary, but always precious thing.

Adolescence is this critical time for youth—the time that often decides whether a person stays in school, remains free of infections like HIV, whether they get pregnant young or not, what their use of drugs or alcohol might look like, and how their social circles develop. But most global health systems have very few services to support all aspects of adolescent health. There are often not places for adolescents to get vaccines or mental health support or family planning services—let alone basic check-ups. Now, I get to focus much of my own work on growing care programs to support adolescent health in places like Kenya.

What is the best part of your job?

I love new ideas. And I love tackling big problems. The very best part of my job is getting to support our multinational teams as everyone collaborates to dream up new ideas that provide better health care and better access to health care for people around the world.

What are you most excited about for the future of the Institute?

At the Institute, we now have the opportunity to change how health care is provided for big groups of people, often living in poor or remote places around the world. We even have the opportunity to work on national health systems and revamping how they provide care to populations like women and children. Being able to have this kind of impact, to be able to be part of scaling up better and more just systems—especially to serve children and women—is so exciting to me.

Do you have any advice for someone looking to go into your field?

I would not be afraid to bring all of yourself to the work that you want to do. For example, I thought that being a book-loving, former English major who loves stories was an interesting part of who I was, but I never thought that it would be part of what it looked like to be a good doctor. In fact, when I started medical school, I thought it might be a real liability that I did not have the kind of science background that many of my peers do. Instead, I learned over time that how we care for people as patients requires us to be very good listeners to their stories. Even more, it is critical to the work I do every single day that I can capture our ideas and their significance in writing.

And, it always helps to stay curious. Once I was in pediatrics, I did not really have any idea what kind of specialty area or focus I might want. I loved taking care of children and addressing the needs of their families, and I had never once thought about a research career. After seeking and questioning during my years of residency, it took a smart mentor to point out to me that I really love working to try to fix health care systems so that they provide better care for the most vulnerable children and their families—and that this was what health services researchers do. I begrudgingly agreed to try out a research elective and quickly discovered that my love of figuring out ideas for how to fix things was actually the perfect basis for growing research. I never wanted to be in a lab or doing statistics, but I absolutely love asking questions about how to best provide care for kids.

What Should I Do If My Child Has Norovirus?

Updated on Feb 24, 2023 | Adolescent Health, Featured, Pediatrics, Your Health

If your child has a stomach bug, it could be norovirus—a highly contagious stomach virus that causes diarrhea and vomiting. Cases of this virus are on the rise in New York City and much of the northeastern United States, according to the Centers for Disease Control and Prevention.

While typically mild in older children and adults, lasting usually only a few days, norovirus can cause severe dehydration in babies and kids with certain underlying conditions. Knowing how to care for them is crucial.

In this Q&A, Tessa Scripps, MD, a pediatrician at the Mount Sinai Kravis Children’s Hospital, and Assistant Professor of Pediatrics at the Icahn School of Medicine and Mount Sinai, answers your questions about the disease, including what to do if your child is sick.

What is norovirus, and what are norovirus symptoms?

Norovirus is a common contagious virus that inflames the intestines, causing nausea, diarrhea, and throwing up. Sometimes it can also cause fever. The disease is spread when particles from an infected person’s feces or vomit spreads to others, typically in bathrooms, but also by eating or drinking contaminated foods and beverages; using contaminated utensils; touching contaminated surfaces; or having any direct contact with someone who is infected. Norovirus is highly transmissible, and infected people can actually shed billions of norovirus particles at a time, but it can take fewer than 100 norovirus particles to make another person sick. People are most contagious when they actively have symptoms and in the few days after their symptoms have resolved.

Tessa Scripps, MD

How can I protect my child from catching norovirus?

The most common way norovirus is spread is through close contact with an infected person, so it’s a good idea to keep kids some distance from people who are sick, or who have recently recovered from being sick. Norovirus can infect an entire family at the same time, since even simple contact with others can lead to infection. So, the most important thing is for kids to wash hands frequently with soap and warm water, and for adults to do the same, especially if any of you have been in contact with a person who has symptoms. Alcohol-based sanitizers do not work as effectively against preventing transmission.

My child has norovirus. How does their age or health condition affect their risk for severe illness?

Newborn babies and children who have underlying chronic illnesses such as kidney disease and diabetes are at higher risk for becoming dehydrated and severely ill because excessive fluid losses can affect their kidney and their liver function. It’s important they get medical attention right away if symptoms last longer than three days or if they’re unable to keep hydrated.

What symptoms might indicate my child needs medical help?

Watch for symptoms of dehydration, such as decreased or less frequent urination and small volume- or very dark or strong-smelling urine. If it has been more than eight hours from when your child has had a wet diaper or used the toilet to pee, reach out to your doctor for advice. A rapid heart rate or a significant change in your child’s activity can also be a sign of dehydration. If you notice that your child seems very lethargic and listless, you should seek medical advice right away.

What can I do to help my child recover from norovirus?

Once the virus has passed and the vomiting and diarrhea have subsided, make sure they are well hydrated and rested. For newborns and infants, you can give them small amounts of breast milk or formula. Toddlers, older children, and adults should drink small volumes of fluids—about one to two ounces every one to two hours—to ensure fluids get absorbed and to prevent recurrent vomiting. Drinking water and electrolyte fluids like Pedialyte^®, Gatorade, or watered down apple juice can be very useful to maintain hydration, and can help prevent complications from norovirus. They can also have bland foods like rice, dry cereal, applesauce, bananas, and crackers.

Are there any medications I can give my child to ease their norovirus symptoms?

There are no over-the-counter anti-diarrheals or anti-nausea medicines that are recommended for children. In rare cases, pediatricians may prescribe Zofran, an anti-emetic, to help children stop vomiting so they can re-hydrate without the need for intravenous fluids.

How do I prevent norovirus from spreading to my other kids?

It is important that everyone in your house washes their hands regularly with warm water, and avoid sharing food and drinking cups with anyone who is sick. You should also wipe down any contaminated surfaces with a bleach-based disinfectant, especially toilets and sinks after an infected child has used them. And everyone should try to maintain some distance from infected household members while they’re actively sick.

Is there a test for norovirus I can give my child?

Testing is available. However, norovirus is similar to other types of stomach infections, such as rotavirus, and symptom management is the same, so testing isn’t useful. If there has been an outbreak at your child’s school and they are sick, there is a good chance they have norovirus.

UPRISE: A New Model for Teen Mental Health and Substance Use Treatment

Nov 18, 2022 | Adolescent Health, Inside Mount Sinai Psychiatry, Mental Health, Psychiatry

“We’re not bound by the traditional therapeutic framework where you meet in an office for a scheduled appointment,” Dr. Weller says. “We literally meet them where they’re at.”

By the time students reach New York City’s Judith S. Kaye High School (JSK), multiple systems have failed them. As a public transfer school for students with significant barriers to their education, many of JSK’s students have faced significant adversity.

“All of our students have been disconnected from school at some point and many have experienced some trauma,” says school principal Andrew Brown. Mental health disorders and substance use problems are common, but linking students to traditional mental health services is nearly impossible. “Even for students who are ready to meet with someone, once they leave the building, the obstacles are frequently insurmountable,” Brown says.

Thanks to Mount Sinai’s UPRISE (Use Prevention Recovery Intervention Services & Education) program, students no longer have to leave school to get the care they need. “Rather than trying to get students to come to us, we provide services on-site,” says Rachel Weller, PsyD, an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai and project manager and clinical supervisor for UPRISE.

The partnership, launched just before the COVID-19 pandemic, is helping students address their mental health problems and substance use, often for the first time. “Having access to this high-quality care, within the school building, is a game changer,” Brown says.

Youth Mental Health: An Unmet Need
JSK, which serves about 145 students at their Manhattan site, is co-located within the School of Cooperative Technical Education (Coop Tech), a career and technical school that serves about 1,500 students. Students from both schools are offered access to mental health and substance use treatment through the UPRISE program.

UPRISE is an offshoot of the Comprehensive Adolescent Rehabilitation and Education Service (CARES), a program of the Addiction Institute of Mount Sinai that has served adolescents and young adults for more than 20 years. CARES provides a therapeutic high school environment that includes a range of targeted services for youth with complex mental health, substance use, and educational problems. While CARES has seen great success, the need for services among New York City youth remains significant. UPRISE is a new model that shows how mental health services can be integrated into a public school setting.

Both Coop Tech and JSK serve historically marginalized populations who have long been subject to systemic racism and discrimination, says Shilpa R. Taufique, PhD, director of the psychology division for the Mount Sinai Health System and director of CARES. “These students and their families have all had the experience of not being seen or heard, and of having institutions impose what they think is best for them,” she says. “There’s such a deep mistrust of the systems that are supposed to be helping them.”

As a result, students have often struggled for years with mental health problems — even before the COVID-19 pandemic made youth mental health a national crisis. “We see many kids present with PTSD, complex trauma, major depression, anxiety, and difficulty with substance use,” Dr. Weller says. “What’s most striking is the number of students who have a longstanding history of mental health difficulties, yet have never received any type of treatment.”

A New Model of School Mental Health
UPRISE aims to give adolescents the tools to help them develop into healthy, functioning young adults. The clinical team is small but mighty: Dr. Weller is on-site in the school most days, along with part-time clinical staff including two postdoctoral fellows and a graduate student extern. They currently provide services for about 30 students, but Weller and her colleagues hope to double that number in early 2023.

UPRISE offers a range of services, including:

Psychoeducation
Individual therapy
Group therapy
Family therapy
Milieu therapy
Substance use treatment
Medication management

In addition to counseling and therapy services, the team helps students connect with prescribing providers via telehealth for medication management. All of these services are billed to students’ insurance companies, making it a model that is both sustainable and replicable, Dr. Taufique says.

Flexible Approaches to Teen Mental Health
Plenty of schools have experimented with embedding social workers or mental health providers in school settings. But UPRISE goes further. Before launching the program, the team spent a year learning about the schools and their students’ unique needs. “People make a lot of assumptions about teenagers, especially young people who have been disconnected from school or who are in treatment,” Brown says. “[The UPRISE team] didn’t come in with any expectations about who these kids are.”

That open-minded attitude has led to several innovations. URPISE takes a novel approach to family therapy, incorporating school staff into students’ treatment plans much like parents or other family members might be included. “The school setting is a surrogate family for most of these students. The teachers, guidance counselors, and social workers are very involved in their students’ lives — these are the people students call in the middle of the night if they’re in crisis,” Dr. Taufique says. “We want to highlight the roles they play in students’ lives and also give school staff some therapeutic framework to draw on so they don’t get burned out.”

Clinicians provide services to students in school during the school day, but they also reach out to them in the community. If a student has a phobia of the subway or anxiety about coming to school, for instance, providers might arrange to travel to school with them to provide a form of exposure therapy. “We’re not bound by the traditional therapeutic framework where you meet in an office for a scheduled appointment,” Dr. Weller says. “We literally meet them where they’re at.”

Services Without Stigma
In addition to services for patients, UPRISE offers psychoeducation and outreach to the entire school community, such as school-wide presentations on topics related to substance use and mental health. The program is also open for a drop-in hour five days a week, so any student in either school can come in to talk whenever they need. “With the drop-in hour, we discuss things that are going on in students’ lives, provide some psychoeducation, and sometimes link students to services or provide referrals,” Weller says. “We want to make this accessible, even to kids we’re not directly serving.”

At a time when most of the news about teen mental health is bleak, UPRISE is making a positive difference in his students’ lives, Brown says. “We have students who are seeing counselors for the first time. They’re showing up to appointments, connecting with counselors. They’re more connected to school.”

“Students look at this as a tool to help them get better and help them transition into adulthood. There’s no stigma attached to it,” he adds. “It’s just become a part of our community.”

Learn more about The Comprehensive Adolescent Rehabilitation and Education Service (CARES) program at Mount Sinai.

When Should Adolescent Congenital Heart Patients Transition to Adult Care?

Mar 31, 2022 | Adolescent Health, Heart Health, Your Health

Asian doctor is using a stethoscope listen to the heartbeat of the elderly patient.

Decades of advances in pediatric cardiology has allowed for children with congenital heart conditions to thrive, growing into adolescents and then adults capable of starting families of their own. However, this does not mean that these adult congenital heart patients should stop seeing their physician.

In this Q&A, Ali N. Zaidi, MD, Director for Adult Congenital Heart Disease at Mount Sinai Heart and Associate Professor of Medicine (Cardiology) and Pediatrics at the Icahn School of Medicine at Mount Sinai, discusses the importance of transitioning to an adult cardiologist and continuing care to ensure that patients can lead long, healthy lives.

What are the different types of congenital heart disease?

Congenital heart disease is a condition that children are born with and can range from the very simple to the very complex. Sometimes children need immediate interventions or operations, and for others, we may simply monitor their condition.

On the simple side, there is an atrial/ventricular septal defect, often called “a hole in the heart,” which is a defect in the wall between the right and left chambers of the heart. These are very common defects and may or may not warrant treatment. More complex congenital heart conditions include a condition called Tetralogy of Fallot, which is four different heart defects, and often does require that the infant or child undergo surgery. Other more complex conditions include transposition of the great arteries, a condition in which the large blood vessels of a child’s heart may need to be rerouted.

What treatments are available?

Sometimes infants or children born with congenital heart disease need an intervention that’s minimally invasive. An example would be a catheterization in which a tube is guided into the heart through the blood vessels for diagnosis or treatment. If there is a major problem, a child may need an open-heart procedure.

Depending on what the congenital heart defect is, these children will need to receive long term evaluation and treatment. This may continue as the child grows, throughout their teenage years, and into adulthood. Almost 90 to 95 percent of children who are born with congenital heart disease survive into adulthood. It’s very important to understand that the treatments we now have are tremendously successful—and these children can grow up and lead typical adult lives. It is now estimated that there are more adults with congenital heart disease than children living with the condition in the United States.

When should an adolescent with a congenital heart condition transition from their pediatric cardiologist to an adult congenital cardiologist?

It’s very important that children and adolescents who are born with congenital heart disease continue to seek appropriate care. Transition of care is a process which often should begin in the teenage years. Sometimes, it takes multiple visits to have an adolescent patient appropriately transitioned to adult-based health care. Transfer of care, however, is a different process in which a patient’s care is “transferred” to an adult congenital heart specialist; this should happen when they are older. There is no hard and fast rule, but by the time a patient is 21 years old, they should be receiving care from an adult congenital cardiologist.

What kind of care should an adult congenital heart patient expect?

Often, patients go for many years without the need for any intervention. But adult congenital heart care often does require interdisciplinary care. There may be kidney, liver, or lung issues that come up as a result of the patient’s underlying condition or as they get older, patients tend to acquire adult-based health conditions like hypertension, diabetes, or coronary artery disease. It is also possible that there may never be a problem, but it is best to follow patients with congenital heart disease on a regular basis.

We also have to think about the social fabric of their lives. Patients grow up and get jobs. They often move to another city or country, they get married, and want to have kids of their own. In doing so, they may pass the condition down to their own children. Young women with congenital heart disease may need to consult with a maternal fetal medicine specialist since some of these patients are considered higher-risk pregnancies. At the Mount Sinai Adult Congenital Heart Disease Center, we bring in this multi-faceted, multi-disciplinary approach to meet the ongoing needs of patients as their lives change, including young women with the condition who are pregnant or are considering pregnancy.

Are there lifestyle considerations that these patients should be aware of?

We always encourage our patients with congenital heart disease to try to have as normal a life as they can. When I see patients who are in their 20s and 30s, and they are doing well, I encourage them to enjoy life and have fun—within measure and with regular follow-ups.. Life should be no different than what it is for somebody without congenital heart disease. We want these young patients to go out there and live full lives, have careers and when able, their own families. We will be there, if and when they need us.

What services does Mount Sinai provide for adult congenital heart patients?

Our adult congenital heart disease program at Mount Sinai is one of the few programs in New York that has been accredited through the Adult Congenital Heart Association. This accreditation confirms that we are providing comprehensive, multidisciplinary care to adolescent and adult patients with all forms of the condition.

What does accreditation mean?

It means that we offer all facets of care when it comes to adult congenital heart disease. At Mount Sinai Heart, we provide state-of-the-art care for all forms of congenial heart disease from adolescents to older adults. We can enlist the Mount Sinai Health System’s world-class physicians to provide multi-disciplinary care be it for pregnant women with the condition, evaluations for transplantation, or cardiac interventions either in the catheterization lab or surgical room. We also provide pulmonary hypertension evaluation and treatment, which is an important part of adult congenital heart disease care. We have a specialized cardiac imaging team here at Mount Sinai exclusively for congenital heart disease providing exceptional multi-modality imaging for our patients. We provide 360-degree care—complete and comprehensive with excellent outcomes.

Is there anything else that patients should know?

I urge adult congenital heart patients to find the right provider and stay in care—that is very important. I see many patients in their 20s and 30s and often they feel fine. At that stage, it is easy to fall out of care and not seek appropriate long term care with an adult congenital heart disease cardiologist. But congenital heart disease is a condition that needs to be followed throughout your life. Find the right adult congenital heart disease program and make sure to follow your physician’s instructions. You’ve got a full life ahead of you and our job is to take you all the way.

Learn more about the Adult Congenital Heart Disease program at Mount Sinai

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