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Autism spectrum disorder and congenital heart disease: a narrative review of the literature

Published online by Cambridge University Press:  26 May 2023

Kritika Nayar Open the ORCID record for Kritika Nayar [Opens in a new window] ,
Lindsay Katz ,
Kimberley Heinrich  and
Natalie Berger
Kritika Nayar*
Affiliation:
Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Department of Psychiatry & Behavioral Sciences, Autism Assessment, Research, & Treatment Services, Rush University Medical Center, Chicago, IL, USA
Lindsay Katz
Affiliation:
Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Department of Pediatric Psychology and Neuropsychology, Nationwide Children’s Hospital, Columbus, OH, USA
Kimberley Heinrich
Affiliation:
Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Natalie Berger
Affiliation:
Department of Psychiatry & Behavioral Sciences, Autism Assessment, Research, & Treatment Services, Rush University Medical Center, Chicago, IL, USA
*
Corresponding author: Dr. K. Nayar, Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. E-mail: kritikanayarphd@gmail.com
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Abstract

Individuals born with congenital heart disease (CHD) are at an increased risk of developing neurodevelopmental disorders. Despite this, studies are limited in their investigation of autism spectrum disorder in the context of CHD. This review provides an overview of the literature examining autism spectrum disorder in CHD and discusses strengths, limitations, and future directions. Recent efforts have been made to extrapolate the association between CHD and symptoms of autism. Findings suggest that the core features of autism spectrum disorder are also implicated in children with CHD, namely social-cognitive weaknesses, pragmatic language differences, and social problems. Compared to norm-referenced samples, separate studies have identified divergent and overlapping neuropsychological profiles among both patient groups, yet there are no studies directly comparing the two groups. There is emerging evidence of prevalence rates of autism diagnosis in CHD showing an increased odds of having autism spectrum disorder among children with CHD relative to the general population or matched controls. There also appears to be genetic links to this overlap, with several genes identified as being tied to both CHD and autism. Together, research points to potentially shared underlying mechanisms contributing to the pathophysiology of neurodevelopmental, neuropsychological, and clinical traits in CHD and autism spectrum disorder. Future investigation delineating profiles across these patient populations can fill a significant gap in the literature and aid in treatment approaches to improve clinical outcomes.

Keywords

Autism spectrum disordercongenital heart diseaseprevalence and incidencesocial communication
Type
Review
Information
Cardiology in the Young , Volume 33 , Issue 6 , June 2023 , pp. 843 - 853
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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