Queensland Cardiovascular Group is delighted to welcome Dr Myo Thidar (Mona) Lwin to our team of cardiology specialists.
Dr Lwin joins QCG after eleven years in the United Kingdom, where she trained and then worked as a Consultant Cardiologist in Adult Congenital Heart Disease at three of the world’s leading centres for the condition. She is one of a small number of cardiologists in Australia with dedicated subspecialty expertise in caring for adults born with heart conditions, and she has returned to Queensland with a clear purpose: to build the kind of ACHD service here that she helped lead in the NHS.
A growing population that Queensland is only beginning to catch up with
Not long ago, most children born with a serious heart condition did not survive into adulthood. That has changed profoundly.
"Now we have got all this amazing care and people are living longer and longer, so we actually have got an explosion of this population now. And looking after these patients is very challenging, because it requires unique experience and expertise really."
Advances in paediatric cardiac surgery over the past few decades mean that the majority of children born with congenital heart disease now reach adulthood. For the first time in medical history, there are more adults living with congenital heart disease than children.
Those adults need lifelong specialist care. Their hearts have been repaired, but they have not been made ordinary, and the way an altered heart behaves as it ages is a specialised field of its own.
Why the United Kingdom, and why congenital heart disease
Dr Lwin completed her general cardiology training in Queensland, through Queensland Health, at The Prince Charles Hospital and Gold Coast University Hospital. She is candid about what that training does and does not prepare a cardiologist to do.
"We're not equipped to look after these patients just after completing our standard cardiology training pathway in Australia. So, the main reason that I went out to the UK was for this dedicated congenital heart disease training and experience."
Her reason for choosing the United Kingdom was practical. Congenital heart disease is, individually, uncommon. Building genuine expertise requires seeing a very large number of patients with a very wide range of anatomy, and that only happens where the population is concentrated around high-volume specialist centres.
"With the geography, patient population is concentrated in one centre. So it's a high-volume centre where you get to experience so many diverse congenital heart diseases, and then you build experience and you learn from the patients essentially."
This matters more in ACHD than in almost any other area of cardiology, because the field cannot lean on large, randomised trials the way other cardiology subspecialties can.
"Our specialty is unique from other cardiology specialties, because they have got quite high-quality research data and evidence, as opposed to us. A lot of the work is based around the expert consensus and experience really. You don't learn how to manage this patient in the textbooks or guidelines."
In other words, in adult congenital heart disease, experience is the evidence base. There is no substitute for having seen it before.
Seven years of dedicated subspecialty training
Dr Lwin spent seven years training exclusively in adult congenital heart disease across three internationally recognised centres. Each contributed a different dimension to her practice.
The three centres that shaped her practice
| Centre | Focus of training |
| University Hospital Southampton | Core adult congenital heart disease, pulmonary hypertension, and maternal and pregnancy cardiology |
| Royal Brompton Hospital, Guy’s and St Thomas’ | Advanced adult congenital echocardiography and transoesophageal echocardiography (TOE) for structural interventions |
| St Bartholomew’s Hospital (Barts Health) | Congenital aortopathy, paediatric to adult transition services, and advanced ACHD imaging protocols |
Her training also included working directly alongside paediatric cardiology colleagues, which she regards as essential rather than optional.
"You need that paediatric experience as well. Part of my training required working with the children's hospital. I work very closely with paediatric colleagues."
Four years as a consultant, and four services led
Following her fellowships, Dr Lwin worked for four years as a full-time Consultant Cardiologist in Adult Congenital Heart Disease within the NHS, at University Hospital Southampton and Barts Health NHS Trust. During that period, she held a series of service leadership roles.
Leadership roles in the NHS
- Led the ACHD Echocardiography Service at Barts Health NHS Trust
- Led the ACHD Transition Service, in partnership with Great Ormond Street Hospital in London
- Led the ACHD Pulmonary Hypertension Service at University Hospital Southampton
- Co-led the Pregnancy Cardiology Service at University Hospital Southampton
She also organised the annual ACHD echocardiography course at Barts and has presented at international, national and regional conferences. Dr Lwin holds specialist registration in both Australia and the United Kingdom.
That combination of high-volume clinical exposure and service design experience is what she is now bringing to QCG. Her interest is not only in seeing patients, but in building the referral pathways, surveillance schedules and multidisciplinary links that a mature ACHD service depends on.
“Finally, something that explains my symptoms”
Ask Dr Lwin what she encounters most often in her Brisbane consulting rooms, and the answer is not a diagnosis. It is a pattern.
Adults with congenital heart disease frequently under-report their symptoms. Many have lived with an altered heart since birth and have no normal baseline to compare themselves against, so a slow decline in stamina simply becomes their new ordinary. When they do raise it, the symptoms are often vague: tiredness, breathlessness on exertion, reduced exercise tolerance. Those symptoms are easily attributed to something else.
"Symptoms of our patient groups are often dismissed as psychological or functional in the community. So, by the time they come to me, there are happy tears, a sense of relief. ‘Finally, we've discovered something that could explain my symptom and I'm not crazy.’ That's a very common theme in my rooms, particularly in Brisbane."
This is not a theoretical concern. In her first four months back in Queensland, Dr Lwin diagnosed five adults with congenital heart disease that had never been identified before. Every one of them has since undergone surgery or a catheter-based intervention.
"All of them have now undergone surgery or intervention. So, they were repaired as adults, which is really rewarding."
Five previously undiagnosed adults in four months, in a single new practice, is a reasonable indication of how many people are living with unrecognised congenital heart disease in this state.
For those five patients, and for the many adults who had a defect repaired in childhood, the procedure is not where care ends.
"Repairing a congenital heart defect is an important milestone, but it is not the end of the journey. People with operated congenital heart disease require lifelong care because new lesions can develop and previous residual lesions can progress over time. Regular follow-up with an adult congenital cardiologist helps ensure that these changes are recognised early and managed appropriately."
A different message for women thinking about family
Dr Lwin co-led a pregnancy cardiology service in the United Kingdom, and maternal cardiology remains one of the areas she finds most rewarding. It is also, she says, one of the areas where women receive the most outdated information, leaving them with a bleaker picture than the evidence supports.
"A lot of the time our young congenital women are told that they can't have family. They’re told that pregnancy is contraindicated, which is completely the opposite of what we say. Most women actually can undergo a successful pregnancy with dedicated care and follow up throughout the pregnancy. And that's entirely possible, even in extremely high-risk conditions. We have many successful stories, but they need to be carefully planned."
There are genuine high-risk conditions where pregnancy carries serious danger, and those need frank, early conversations. But they are the exception. For the majority of women with mild to moderate congenital heart disease, pregnancy is achievable safely, provided it is planned rather than unplanned, and provided the right team is involved from before conception through to postpartum care.
That is why Dr Lwin is particularly keen to see women referred early, ideally for a pre-conception assessment rather than after a pregnancy has already begun.
What this means for Queensland patients
Dr Lwin’s practice at QCG covers the full breadth of adult congenital heart disease.
Clinical interests
- Adult congenital heart disease, from simple repaired lesions through to complex conditions including Fontan circulation, Tetralogy of Fallot, transposition of the great arteries, Ebstein anomaly and coarctation
- Congenital aortopathy, including bicuspid aortic valve, Marfan syndrome, Loeys-Dietz syndrome and Turner syndrome
- Pulmonary hypertension associated with congenital heart disease
- Pregnancy cardiology, including pre-conception risk assessment, pregnancy monitoring and postpartum care
- Advanced echocardiography, including stress echocardiography and transoesophageal echocardiography to guide structural procedures such as ASD and PFO closure
Until recently, many Queensland adults with congenital heart disease had limited local options for genuinely subspecialised review. Dr Lwin’s arrival changes that.
Referring to Dr Lwin
Dr Lwin welcomes referrals from general practitioners, general cardiologists, obstetricians and paediatric colleagues. Her guidance to referrers is straightforward.
"If you're not sure, just refer: that can be a phone call or an email, or a formal referral. A lot of the time we are able to provide shared care with the GP. But the message is to refer sooner rather than later, particularly when it comes to pregnancy."
When to refer
- Any adult with a known history of congenital heart disease who is not under current specialist cardiology follow up
- Young adults who have left paediatric cardiology services and have not transitioned into adult care
- Women with congenital heart disease who are pregnant or considering pregnancy, ideally before conception
- Adults with unexplained breathlessness, fatigue, palpitations, syncope or reduced exercise tolerance where a structural cause has not been excluded
- Patients requiring advanced congenital echocardiography or imaging assessment before a structural intervention
Shared care arrangements with referring GPs are welcomed, and Dr Lwin is happy to be contacted informally by phone or email where a referrer is unsure whether a referral is warranted.
To arrange an appointment with Dr Lwin, please contact Queensland Cardiovascular Group on (07) 3016 1111 or submit a referral through our Referrers page.
If you are a patient and your GP has provided you with a Cardiology referral, please contact our team directly to arrange an appointment by phone on (07) 3016 1111 or via our enquiry form online.
