Cardiovascular Disorders in Children with Down Syndrome

Down syndrome (DS) is commonly associated with cardiovascular disorders either congenital or acquired. Congenital cardiac diseases (CHDs) occur in about half of children with DS. They also are more liable to have pulmonary hypertension, mitral valve prolapse, aortic regurgitation and many other acquired cardiac conditions. Meanwhile, they are also of a higher risk for developing obesity than the control children which predisposes them to an increased risk of atherosclerosis. Antenatal detection of DS as well as CHDs can be detected by presence of some soft signs during routine antenatal 4-chamber view. Children with this syndrome should have echocardiographic examination in the first month of life for all neonates, before any cardiac surgery, as follow-up after cardiac surgery, for serial evaluation of pulmonary hypertension, before involvement in major non-cardiac surgery and before involvement in physical exercise as well as serial follow up for early detection of any cardiac disorder. In this chapter, prevalence, pathomechanism and methods of detection of cardiac disorders in children with DS as well as their management are discussed.

Keywords: Aberrant right subclavian artery, Atrioventricular septal defects, Cardiac functions, Children, Congenital Cardiac Diseases, DSCR1 gene, Down syndrome, Echogenic intracardiac foci, Fallout Tetralogy, Fetal echocardiography, Hypothyroidism, Mitral Valve prolapse, Nuchal translucency, Over-expression, Patent ductus arteriosus, Pathomechanism, Pericardial Effusion, Single umbilical artery, Soft signs, Ventricular septal defects.