Acquired valvular heart disease

Congenital heart disease is the most common cardiac problem in individuals with Down syndrome. Today, most congenital heart defects either heal on their own or are surgically corrected before the child starts kindergarten. As individuals with Down syndrome age, however, they may develop valvular dysfunction. Usually these new heart problems develop in adulthood, but some teens with Down syndrome are susceptible as well. Interestingly enough, valvular disease is seen in individuals with Down syndrome who have no history of congenital heart disease, as well as those who were born with heart defects.

When working with teens who have valvular disease, it’s important to determine the physician’s recommendations for prophylactic treatment for subacute bacterial endocarditis (SBE) and counsel the patient when indicated. SBE prophylaxis involves preventive antibiotic therapy before dental cleanings and other invasive procedures.

Because adolescents with Down syndrome often have immunological impairments and pulmonary hyperplasia, they are at increased risk for respiratory infections. These infections can be quite severe and occasionally fatal. Nurses working with teens with Down syndrome can help identify respiratory infections, encourage prompt treatment, and follow up to check for secondary infections or declining respiratory status. It’s important that both the adolescent and the parents understand the need to seek treatment right away, rather than adopting the "wait and see" attitude common among many older adolescents.

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