Inpatient cardiac and respiratory physiotherapy management of a child with Down syndrome who underwent surgical repair of congenital heart disease: A case report

Abstract

Down syndrome (DS) is characterized by the presence of all or a portion of the third chromosome 21. In this population, congenital heart disease (CHD) is the primary cause of death and morbidity in the first two years of life. Atrioventricular septal defect (AVSD) is the most common CHD seen in DS patients, followed by an atrial septal defect (ASD), ventricular septal defect (VSD), and tetralogy of Fallot (TOF). There is a high possibility of serious cardiac abnormalities in DS patients thus; there must be a protocol in place for early screening, prompt diagnosis and early operative measures. Due to advancements in technique and postoperative care over the last few years, the prognosis following surgical repair has substantially improved. Most of the post-operative strategies for patients with CHD can be applied to patients with DS. Physiotherapists play an important role in managing patients after the surgical repair of cardiac abnormalities. They also help in facilitating physical activity in children with DS. Our case report aims to provide the post-operative physiotherapy protocol for a child with DS operated for the closure of ASD and VSD along with the ligation of Patent Ductus Arteriosus (PDA). The main aim of post-operative cardiac and respiratory physiotherapy management was to clear lung secretions, promote healthy healing of the incision, maintain patency of lungs, reduce work of breathing and improve chest mobility while addressing delayed developmental milestones. The case report illustrates the importance of inpatient post-operative physiotherapy management which will lead to a gain in the existing knowledge while dealing with such patients.