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, its important to determine the physicians
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.
Its 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.