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. However, as adults with Down syndrome age, they may develop valvular dysfunction. Interestingly enough, valvular disease is seen in adults with no history of congenital heart disease, as well as those who were born with heart defects.

As many as 57% of the adults with Down syndrome have mitral valve prolapse and 17% have valvular regurgitation. Nurses working with these adults should 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.

Only adults with a history of congenital heart disease are at risk for valvular heart disease as they age.