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Out of a group of 113 cases of Down's syndrome 50 were associated with congenital heart disease, confirmed by haemodynamic, angiographic and surgical means. The mean age was 36.6 months. Twelve were cyanotic, six of them because of an inverted previous left-toright shunt. The endocardial cushion defect, alone or in association, accounted for 40% of these anomalies, and ventricular septal defect for 26%. If the cases with right ventricle outflow obstruction are excluded, 50% presented pulmonary pressures over 70 mmHg. In addition, 80% of endocardial cushion defects presented pulmonary hypertension, being the three fourths under one year of life. On the basis of the data presented, authors remark the need of an early approach to specialized diagnosis of these children, in order to allow an earlier surgical correction or palliation than in children without Down syndrome.
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