CARDIAC (HEART) DEFECTS
المؤلف:
FRANK GARVEY AND JACKY VINCENT
المصدر:
Caring for People with Learning Disabilities
الجزء والصفحة:
P130-C8
2025-10-21
270
CARDIAC (HEART) DEFECTS
Defects within the heart of adults with Down’s syndrome are common. Abnormal embryological cardiac development can result in cardiac structural defects. Between 40 and 50 per cent of babies with Down’s syndrome have congenital heart defects (Tubman et al. 1991), including atrial and ventricular septal abnormalities, in which blood is inappropriately shunted through structural defects in the atria or ventricles, respectively. The shunting of the blood reduces the effectiveness of the oxygenation function of the blood, resulting in fatigue and cyanosis. Cyanosis can be seen when the skin of the extremities and the mucous membranes turn a dusky blue color and are cold to the touch. Central cyanosis is seen in the tongue and the lips turn blue, as arterial blood becomes deplete.
Many adults with Down’s syndrome have incompetent mitral valves caused by weakening of the valve subsequent to the cardiac infection sub-acute bacterial endocarditis and, as such, require prophylactic preventative antibiotic therapy for dental investigation, as the infective agent can easily gain access to the body through a cut within the mouth. As the student or carer, it is essential that you ensure antibiotics are taken by an adult with Down’s syndrome prior to dental treatment, where this is necessary.
Patent ductus arteriosis occurs as the embryonic duct connecting the aorta and pulmonary artery fails to close, resulting in inefficient blood passage throughout the body. Many of these congenital cardiac defects are surgically reversible but rely upon early detection. A high level of clinical suspicion about the presence of cardiac abnormalities must exist for all children with Down’s syndrome. Structural defects may well only be symptomatic later in life and missed if echocardiograms have not been utilized in the diagnostic process. It is recommended that screening echocardiograms are employed in the early adulthood of all people with Down’s syndrome. Early corrective intervention is essential to minimize the chance of secondary pulmonary disease occurring.
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