Medical Emergencies · patient case question
Which systemic consideration is most important before invasive dental treatment?
Patient case: Girl with Down syndrome attending for treatment
Patient: Girl with Down syndrome (trisomy 21), a minor
Chief complaint: Attends with her mother for examination and treatment.
Background: Trisomy 21. Mother is the primary caregiver.
Current findings: Panoramic radiograph and intraoral examination performed.
Show answer and explanation
Correct answer: B. Screening for congenital heart disease
- A. Adrenal insufficiency is not characteristic, though thyroid disease — particularly hypothyroidism — is common.
- B. CORRECT. Roughly 40–50% of individuals with Down syndrome have CONGENITAL HEART DISEASE, most commonly atrioventricular septal defects. Cardiac status must be established, and whether antibiotic prophylaxis is indicated determined against current American Heart Association criteria. Atlantoaxial instability is a second important concern, affecting neck positioning in the chair.
- C. Malignant hyperthermia has no association with trisomy 21.
- D. Coagulopathy is not a characteristic feature.
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