1. Talking about sex & contraception!
Scenario 1
14 year old Fontan patient comes to clinic. She has heavy periods and asking for advice. What are the contraceptive options for her to consider?
  Scenario 2
A 13 year old female attends clinic in the York clinic with her Dad. She has had repair of AVSD mild mitral regurgitation and seen in clinic every 2 years. She is very quiet, Dad does all the speaking and he appears very overprotective. How would you start the conversation about contraceptive choices and pregnancy risks?
  Scenario 3
A 13 year old female attends cardiology clinic with diagnosis of mixed aortic valve disease. She has an echo in clinic and the gradient has increased significantly over the last 12 months since the last appointment. It needs monitoring more closely so appointments are changed from 12 to 6 monthly. What advice is needed in relation to pregnancy risk & counselling?
 Scenario 4
A 15year old female attends clinic with her parents. She has cyanotic palliated congenital heart disease, Downs’s syndrome and moderate learning disability. She attends mainstream school and has started to go to the local youth club that is run for young people with LD. Start a conversation about relationships & consider contraceptive options with the family.