Conclusion
Teens growing up with CHD are in many ways similar to their peers. The fact that they have a congenital heart defect has set them apart from their peers and therefore has created a situation whereby a need to feel normal is often heightened. Fitting in with peer groups is important to this group. A discussion surrounding the issues that enable a teen to feel like they fit in (such as grades, scars, employment, and physical activity) will create opportunities for health care practitioners to address quality-of-life issues. Deciding when to play their CHD (card) and when to move their CHD to the foreground or background of their lives has enabled these teens to best cope with the obstacles they have encountered. In a discussion about quality of life with teens, understanding this concept is foremost if one is to get at the core of the issues at hand.