Dr. ShahAlamCase 1 Session 3Treatment:For VSDLasix: diuretic to decrease blood flow volume which is causing edema and decrease fluid in the lungsDiagotoxin: increases the strength of the hearts contractions.Surgical Patching of VSD via atriotomy (as the medication alone was not treating the VSD and surgical intervention was required).For Downs SyndromeAs downs syndrome cant be treated symptomatically or physiologically the only treatment is psychological, mental and social.Infants Stimulation Program and neighbourhood support groups.Causes:Chromosomal abnormality trisomy 21 which causes downs syndrome.Symptoms:Of VSDPoor feeding: caused by the excess of fluid accumulated in the lungs due to the VSD which caused fatigue while feeding. Hyperventilation (same reason as above)Cardiomegaly (decreased blood flow in left ventricle due to shunt, causes heart muscles to enlarge in vain compensation to pump what little volume of blood is left with enough pressure)Holosystolic murmur (direct result of VSD)Biventricular hypertrophy (as a result of VSD and hypertension)Downs SyndromeDelay in rolling (hypotonia caused by slow muscle contraction due to downs syndrome and due to malnutrition caused by the VSD)Non-productive cough (as down syndrome babies are more susceptible to chest infections)Brushfield Spots and Simian Crease Present (harmless physical symptom of Downs syndrome)

Tests:ECG: normal except for the abnormal positive T wave in V1.PA Chest Film: indicated normal heart size but with increased pulmonary markings (as a result of excess fluid caused by VSD).Catheterization: to confirm the VSD. Echocardiogram: to diagnose the VSD and cardiomegaly, decreased contractility in the heart (specifically the dilated left ventricle and right atrium).

DOWN SYNDROME + VENTRICULAR SEPTAL DEFECT (VSD)