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Cardiovascular malformations in Omani Arab children with Down's syndrome
Olufemi Jaiyesimi1, Vijaymani Baichoo
1Department of Paediatrics, Buraimi Hospital, Sultanate of Oman. efjay@omantel.net.om
Insights
Congenital heart defects are common in Omani children with Down syndrome, with atrioventricular septal defects being most frequent. Early echocardiography is crucial for timely intervention in these high-risk infants.
Area of Science:
- Pediatric Cardiology
- Clinical Genetics
- Congenital Heart Disease
Background:
- Congenital cardiac malformations in Down syndrome vary globally.
- Data on Arab children with Down syndrome are limited.
- This study addresses the gap in knowledge for Omani Arab children.
Purpose of the Study:
- To determine the prevalence and pattern of congenital heart malformations in Omani Arab children with Down syndrome.
- To provide data specific to an underrepresented ethnic group.
Main Methods:
- Prospective study of Omani children with Down syndrome.
- Clinical evaluation and echocardiography were performed.
- 110 children were consecutively recruited.
Main Results:
- 57% of children had cardiovascular malformations (63 out of 110).
- Atrioventricular septal defect was the most common (32%), followed by atrial septal defects (29%), patent ductus arteriosus (17%), and ventricular septal defects (14%).
- Less common defects included Tetralogy of Fallot and coarctation of the aorta.
Conclusions:
- High prevalence (57%) of cardiovascular malformations in Omani children with Down syndrome.
- Most defects involve left-to-right shunts, posing a risk for pulmonary hypertension.
- Recommend echocardiography within the first month of life for all infants with Down syndrome for early detection and management.
Background And Aim:
Reports from several countries suggest that the prevalence and spectrum of the congenital cardiac malformations seen in the setting of Down's syndrome vary in different ethnic groups and countries, and at different periods in the same country. Data on Arab children are lacking. Our study aimed to fill that void by ascertaining the pattern in Omani Arabs.
Methods:
Prospective clinical and echocardiographic evaluation of consecutively recruited Omani children with Down's syndrome.
Results:
We studied 110 children, aged from one day to 11 years, with a median of 2 months, detecting 76 cardiovascular malformations in 63 (57%) of them. Atrioventricular septal defect, the most prevalent lesion, accounted for 24 (32%) of the 76 defects. Next were atrial septal defects within the oval fossa (29%), patency of the arterial duct (17%), and ventricular septal defect (14%). There were only two cases of Fallot's tetralogy, one each of coarctation of the aorta and right-sided heart, respectively; and none of discordant ventriculo-arterial connections.
Conclusion:
The prevalence of cardiovascular malformations is high, at 57%, in our studied population of Arab children. Overall, 92% of the malformations are defects which are characterized by a left-to-right shunt, and the potential for pulmonary hypertension. These findings underscore the need for early detection and prompt, appropriate care. To achieve this, if feasible, all babies born with Down's syndrome should have echocardiography in the first month of life.
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