When ACHD patients leave for college, there can be gaps in care. To ensure that you can maintain your health, it is important to make an appointment to see your cardiologist at least six months before you leave for college to be sure all necessary tests have been performed (electrocardiogram, echocardiogram, etc.). Before you leave for college, you should follow these steps:
- Know your health history including past surgeries and/or catheterization procedures that you had, even as a baby
- Keep an up-to-date list of your allergies and medications including any infective endocarditis prophylaxis, anticoagulation and contraceptives
- Build a health portfolio. While you are with your cardiologist, ask for copies of your electrocardiogram, echocardiogram and other imaging tests to take with you to college. These are two example health passports:
- Set up your Medical ID in the Health app on your phone. Here are resources to help:
- Identify the nearest adult congenital cardiologist to your college. This can be discussed with your cardiologist or by looking at the Adult Congenital Heart Disease Clinic Directory
- If necessary, consider how campus residential and campus disability services can help you. For example, if your dorm does not have an elevator, residential services can help get you a room on a lower level. Do you need more time on exams? The campus disability services office can assist with this as well
When you arrive to college, remember these key things:
- Maintain insurance coverage and carry your health insurance card along with your ID with you at all times
- Make an appointment with student health services and provide a copy of your medical records
- Have a plan to refill your medications at a pharmacy convenient to campus
- Remember that excess alcohol, caffeine and use of recreational drugs and some nutritional supplements can trigger complications of your condition
- Prepare for emergencies. If you do have a medical emergency or hospitalization, be sure to ask that your medical records are sent to your primary care doctor and ACHD doctor
For additional information:
For Providers of Pediatric ACHD Patients
At the Mass General Adult Congenital Heart Disease program, we encourage patients to become active participants in their care. If you are a pediatric provider wishing to refer your patient to our clinic in the future, a member of our team would be happy to meet with you and your patient virtually. Introducing your patient to specialists at the Mass General ACHD clinic while he or she remains in your care will increase their comfort and confidence in communicating with health care providers, which will help to prepare them for their transition to the adult system.
If you are an adult provider caring for patients with CHD between the ages of 18-30, many of these considerations will be relevant for referral to an ACHD specialist. As a result of their past medical and surgical history, patients with CHD may experience complications such as dysrhythmias, hypertension, heart failure, stroke, liver or renal disease, endocarditis or pulmonary hypertension. Our specialists can provide lifelong surveillance for patients with complex medical conditions, offer resources for associated anxiety/depression, or assist patients with disabilities to navigate a complex medical system. Our providers also provide support for women with CHD who are pregnant or planning to start a family in the near future.
Key considerations when preparing patients for college:
- Work with students to obtain copies of medical records
- Encourage patients to keep medical records organized. Provide resources such as a “My Personal Health Passport”
- Empower patients to set up their Medical ID in the Health application on their phone
- Identify new or worsening symptoms as they require prompt attention and refer to specialized services. Identify local ACHD clinics when possible
- Weigh health risks of prescriptions for contraceptives, antidepressants and even some antibiotics in the context of potential associated risk for thrombi and arrhythmias
- Discuss alcohol consumption and avoidance of recreational drugs as it may trigger arrhythmias and can impact ventricular function
- Facilitate access to chronic medications and device monitoring as it is important that both remain uninterrupted through the college years
- Consider coordination with university health services and campus disability services
College Transition Team Members
Ami Bhatt, MD
Dr. Ami B. Bhatt is the director of the Adult Congenital Heart Disease Program at the Massachusetts General Hospital and an associate professor at Harvard Medical School. She graduated Harvard College, Yale Medical School and completed residency training in medicine and pediatrics at Brigham and Women’s Hospital and the Children’s Hospital of Boston. She is an active clinical cardiologist, investigator and educator and founded the Mass General Adult Congenital Heart Disease program in virtual care in 2013. Her research centers on identifying and implementing cardiovascular telemedicine care and using digital health to improve upon transition education for adolescents and young adults. Dr. Bhatt serves locally on the Board of the American Heart Association to increase awareness, access and patient self-advocacy and empowerment to engage in their care.
Dr. Doreen DeFaria Yeh completed her Internal Medicine Residency at Massachusetts General Hospital and Cardiovascular Disease and Echocardiography fellowships at the University of California at San Francisco, with advanced training in adult congenital heart disease (ACHD) and cardio-obstetrics. She currently serves as the director of the Mass General Cardiovascular Disease Fellowship Training Program, associate director of the Mass General ACHD Program and co-director of the Mass General Cardiovascular Disease and Pregnancy Program. She is board certified in internal medicine, adult cardiovascular disease, ACHD and echocardiography with certification from the National Board of Echocardiography for Adult Comprehensive Echocardiography.
Dr. DeFaria has been recognized for her commitment to excellence in patient care and education. She was selected as one of the American College of Cardiology 2012 Emerging Faculty and received the Brian McGovern Memorial Award from the Department of Medicine in 2012 and 2016 for Excellence in Clinical Teaching in cardiology. She also received the Mass General Department of Medicine Fellowship as part of the Eleanor and Miles Shore Scholars in Medicine from Harvard Medical School. In 2013 she was awarded the Clinician Teacher Development Award, a 4-year grant supported by the Massachusetts General Hospital Physicians Organization and Center for Diversity and Inclusion, project titled: Redefining ACHD Education. With this support she was able to serve as the primary editor of the clinical handbook Adult Congenital Heart Disease in Clinical Practice, published in 2018. Most recently she has received the Cardiovascular Disease Fellowship Excellence in Clinical Education Award. She has authored numerous peer-reviewed publications and currently is the chair of the American Heart Association Laennec Post Graduate Education Committee.
Her clinical focus is ACHD, pregnancy and cardiovascular disease, particularly high-risk cardiac conditions in pregnancy. Dr. DeFaria speaks regionally and nationally on these topics.
Dr. Chris Learn is board certified in internal medicine, general pediatrics, cardiovascular medicine, pediatric cardiology, adult congenital heart disease and adult echocardiography. His interests include adult congenital heart disease, heart disease in pregnancy and echocardiography. He is also active in advocacy for congenital heart disease. He is a member of the Adult Congenital Heart Association and the Alliance for Adult Research in Congenital Cardiology.
Nicole Jones, RN, BSN, CCRN
Nicole Jones is a resource nurse on the Cardiac Arrythmia Step Down Unit at Massachusetts General Hospital. She graduated from the University of Massachusetts in Boston with a bachelor of science in nursing. She is currently pursuing her doctoral degree from the University of Massachusetts, Amherst with plans to graduate in 2021. She has completed clinical training at Massachusetts General Hospital and Brigham and Women’s Hospital. She maintains certifications in critical care, basic life support and advanced cardiac life support. Nicole values the importance of professional collaboration which inspired her to join the Cardiac Practice Committee at Massachusetts General Hospital in 2019. She is also member of the American Association of Critical Care Nurses. Continuing education has enabled her to promote leadership among interdisciplinary teams and provide necessary evidence to influence future practice. As a prospective nurse practitioner, her ultimate goal is to enhance primary care of individuals within traditional, vulnerable and culturally diverse families by integrating research findings and professional standards into practice.
Lauren McLaughlin, RN
Lauren McLaughlin is the Adult Congenital Heart Disease clinic nurse. She worked for over 30 years in cardiac intensive care, and has also worked as a visiting nurse, in school nursing and in cardiac rehab. She provides health and wellness education, and she enjoys supporting young adults as they transition from pediatric care to autonomous adult care. She is married, the mother of three young adult children and enjoys traveling, hiking, reading and gardening.