A child with Down syndrome requires dental treatment. Why would you refer this patient for a cardiology evaluation?

Congenital heart disease (CHD) is present in approximately 40–50% of individuals with Down syndrome. The most common CHD in Down syndrome is the atrioventricular septal defect (AVSD), also called atrioventricular canal defect or endocardial cushion defect, which accounts for approximately 40–45% of CHD in this population. Other common defects include ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus. In dental practice, these patients may require antibiotic prophylaxis against infective endocarditis (per AHA guidelines) and cardiology clearance before certain procedures.