"Children are not just small adults."
It’s a common refrain among care providers when describing how drastically different the care of a young patient can be, relative to an older person with the same ailment.
But as medicine has improved, children who used to succumb to congenital ailments early in life survive well into adulthood, and now, physicians are saying the opposite is true as well: adults are not just large children.
"A few decades ago, there wasn’t any kind of treatment available for children born with, for example, a single ventricle in their heart. Today, we’re seeing those children thrive well into adulthood,” said Michael Joynt, assistant professor of Pediatrics, Cardiology at Golisano Children’s Hospital. “The challenge as physicians is that we don’t know what a ‘normal’ 40-year-old single-ventricle heart looks like, because these patients didn’t exist until recently.”
The new set of patients — adults with congenital heart disease — created a dilemma among care providers. Pediatric cardiologists weren’t used to following patients into their 20s, 30s, and 40s.
Meanwhile, adult cardiologists didn’t have much experience dealing with congenital heart ailments, since most patients with these ailments didn’t grow old enough to age into their care. But the need for care was rising quickly; adults with congenital heart disease were the fastest-growing group of patients in any area of cardiology over the past decade.
Joynt is among the physicians helping to cross this new frontier in medicine. As a graduate of the UR School of Medicine and Dentistry’s Med-Peds program, he is double-boarded in Internal Medicine and Pediatrics, giving him expertise in both areas. And after graduating, he spent four years in fellowship at the University of Michigan —three in pediatric cardiology, and an additional year in Adult Congenital Cardiology.
Now, he’s prepared to help patients with a variety of conditions —single ventricle hearts, Tetralogy of Fallot, transposition of the great arteries, and Ebstein’s Anomaly and others —transition from pediatric care starting in their teenage years.
“There are now more adults with congenital heart disease than children,” said Joynt. “So we’re really looking to build this program and make sure these patients get the care they should.”