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DOI: 10.5935/abc.20190024 Clinical data The patient has developed no symptoms since birth, when heart disease was diagnosed by the presence of heart murmur in the presence of physical elements of Down syndrome. The patient is currently able to walk approximately 30 minutes daily without showing signs of fatigue and accompanies other individuals normally. The patient uses enalapril and levothyroxine for hypothyroidism. Physical examination: good overall status, eupneic, acyanotic, normal pulses in the 4 limbs. Weight: 41 kg, Height: 131 cm, MBP in the right upper limb: 110 x 60 mmHg, HR: 93 bpm, Sat O2: 97%. Precordium: non-palpable ictus cordis, without systolic impulses. Accentuated and constant split second heart sound. Moderate intensity holosystolic murmur at the left lower sternal border and ejection murmur at the high border. Non-palpable liver and lungs clear to auscultation.

Case 2 / 2019 - Complete Atrioventricular Septal Defect, with Down Syndrome, without Pulmonary Hypertension and Natural History at 33 Years of Age