Cardiovascular complications of Down syndrome: Scoping review and expert consensus


Konstantinos Dimopoulos, Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (K.D., A.C.).
Andrew Constantine, Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (K.D., A.C.).
Paul Clift, Department of Cardiology, Queen Elizabeth Hospital Birmingham, United Kingdom (P.C.).
Robin Condliffe, Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C.).
Shahin Moledina, National Paediatric Pulmonary Hypertension Service UK, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom (S.M.).
Katrijn Jansen, Adult Congenital and Paediatric Heart Unit, Freeman Hospital Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (K.J.).
Ryo Inuzuka, Department of Pediatrics, The University of Tokyo Hospital, Japan (R.I.).
Gruschen R. Veldtman, Scottish Adult Congenital Cardiac Service, Golden Jubilee Hospital, Glasgow, Scotland, United Kingdom (G.R.V.).
Clifford L. Cua, The Heart Center, Nationwide Children's Hospital, Columbus, OH (C.L.C.).
Edgar Lik Tay, Department of Cardiology, National University Hospital Singapore (E.T.L.W.).
Alexander R. Opotowsky, The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, OH (A.R.O.).
George Giannakoulas, Department of Cardiology, AHEPA University Hospital School of Medicine, Aristotle University of Thessaloniki, Greece (G.G.).
Rafael Alonso-Gonzalez, Division of Cardiology, Toronto General Hospital, University Health Network, Peter Munk Cardiovascular Center, University of Toronto, Canada (R.A.-G.).
Rachael Cordina, Department of Cardiology, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, New South Wales, Australia (R.C.).
George Capone, Down Syndrome Clinical and Research Center, Kennedy Krieger Institute, Baltimore, MD (G. Capone).Follow
Judith Namuyonga, Department of Paediatric Cardiology, Uganda Heart Institute, Kampala (J.N.).
Charmaine H. Scott, University Hospital of the West Indies, Kingston, Jamaica (C.H.S.).
Michele D'Alto, Department of Cardiology, University "L. Vanvitelli"-Monaldi Hospital, Naples, Italy (M.D.).
Francisco J. Gamero, Department of Cardiovascular Surgery, Benjamin Bloom Children's Hospital, El Salvador (F.J.G.).
Brian Chicoine, Advocate Aurora HealthFollow
Hong Gu, Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, China (H.G.).
Alisa Limsuwan, Division of Pediatric Cardiology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (A.L.).
Tosin Majekodunmi, Department of Cardiology, Euracare Multi-specialist Hospital, Nigeria (T.M.).
Werner Budts, Division of Congenital and Structural Cardiology, University Hospitals Leuven, and Department of Cardiovascular Science, Catholic University Leuven, Belgium (W.B.).
Gerry Coghlan, Department of Cardiology, Royal Free Hospital, London, United Kingdom (G. Coghlan).
Craig S. Broberg, Knight Cardiovascular Institute, Oregon Health and Science University, Portland (C.S.B.).


Advocate Medical Group Adult Down Syndrome Center


Cardiovascular disease is a leading cause of morbidity and mortality in individuals with Down syndrome. Congenital heart disease is the most common cardiovascular condition in this group, present in up to 50% of people with Down syndrome and contributing to poor outcomes. Additional factors contributing to cardiovascular outcomes include pulmonary hypertension; coexistent pulmonary, endocrine, and metabolic diseases; and risk factors for atherosclerotic disease. Moreover, disparities in the cardiovascular care of people with Down syndrome compared with the general population, which vary across different geographies and health care systems, further contribute to cardiovascular mortality; this issue is often overlooked by the wider medical community. This review focuses on the diagnosis, prevalence, and management of cardiovascular disease encountered in people with Down syndrome and summarizes available evidence in 10 key areas relating to Down syndrome and cardiac disease, from prenatal diagnosis to disparities in care in areas of differing resource availability. All specialists and nonspecialist clinicians providing care for people with Down syndrome should be aware of best clinical practice in all aspects of care of this distinct population.



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