COR LOE Recommendation IIa B-NR Genetic testing for 22q11 deletions is reasonable for patients with conotruncal Synopsis Patients with genetic syndromes may have phenotypic manifestations and associated CHD as clinical features of the genetic abnormality. An underlying chromoso- mal abnormality exists in at least 10% of infants with CHD and may not have been previously tested in pa- tients with ACHD.S3.9-3 Clinicians caring for patients with ACHD should recognize the potential for undiagnosed genetic abnormalities that may affect overall health (Table 10) and pursue appropriate evaluation. CLINICAL STATEMENTS AND GUIDELINES Recommendation-Specific Supportive Text Several forms of CHD may be associated with un- derlying genetic syndromes (Table 10). Some ge- netic syndromes may not be phenotypically appar- ent in adults, and prior childhood genetic workup may not be readily available; therefore, genetic syndromes may be missed in patients with ACHD. Many of these syndromes may have important clinical comorbidities, including but not limited to learning disabilities, psychiatric conditions, and re- productive disorders. Up to 5% of children born with CHD have DiGeorge syndrome (22q11.2 dele- tion), the congenital heart defects most commonly associated being those of conotruncal origin. Di- George syndrome is an autosomal dominant con- dition. Therefore, genetic testing is reasonable for patients with ACHD with conotruncal defects for recognition and management of comorbidities and for counseling on the potential risk of recurrence in 3.10. Acquired Cardiovascular Disease Patients with ACHD can acquire other cardiovascular diseases such as hypertension, atherosclerotic coronary artery disease, vascular disease, stroke, and HF.S3.10-1 S3.10-3 The impact of acquired heart disease is increasing as the lifespan of patients with ACHD extends. 