Down's syndrome; congenital heart disease in children, an experience in Faisalabad Pakistan

To evaluate the various types of congenital heart defects and to determine their frequency in children with Down's syndrome. Descriptive study. Department of Pediatrics, Independent University Hospital Faisal Abad Pakistan, from January 2010 to December 2012. 93 children between the ages of day 1 to 12 years, diagnosed clinically as Down's syndrome based on its characteristic phenotypic appearance, were included in the study. A detailed history, physical examination and evaluation of cardiovascular status [including Chest x-ray, Electrocardiogram and Echocardiography] were performed in each Down's syndrome case. Variables of interest included age, sex, maternal age at birth and type and frequency of congenital heart disease. Congenital heart disease was present in 48 [51.62%] children out of 93 children with Down's syndrome. Congenital cardiac defects in order of predominant type and their frequency included Ventricular septal defect [29, 60.4%], Atrioventricular septal defect [14, 29.1%], Atrial septal defect [2, 4.1%], Patent ductus arteriosis [2, 4.1%] and Tetralogy of Fallots [1, 2%]. 68 [73.2%] Down's syndrome children [n=93] presented during their first year of life with mean age of 7 +/- 4 months. Male predominance was observed in both with and without congenital heart disease Down's syndrome children [male: female 1.7:1 and 2.5:1 respectively]. Mean maternal age at birth was 27 +/- 2 years. Congenital heart disease [CHD] is frequently associated with Down's syndrome [DS]. Ventricular septal defects and atrioventricular septal defects are the most common forms of CHDs in DS children of our region. Their earlier presentation [in infancy] and significant contribution to the morbidity and mortality of DS children warrants early diagnosis of DS and mandatory screening of all DS children for associated CHDs