Counsel a young woman with a Fontan circulation on contraception, pregnancy, and staying in care — OSCE

Candidate brief (5 minutes to read)

You are the registrar in the adult congenital heart disease clinic. A 19-year-old woman with a single ventricle palliated to a Fontan circulation has returned after a two-year gap in care. She has a new partner, wants advice about contraception, and says she might want children one day. She feels reasonably well but is breathless on stairs. In eight minutes, re-engage her in care without judgement, advise on safe contraception, counsel realistically about a future pregnancy, address endocarditis prophylaxis, and agree a lifelong follow-up plan. ^{[1] [4]}