down syndrome associated with epstein’s anomaly and pulmonary hypertension in a 2.5 months infant: a case report study

In children with down syndrome (ds) there is higher chance for concomitant congenital heart defects and organic disorders. however epstein’s anomaly is a rare association of ds. we report a 2.5 months ds boy that referred to our hospital with tachypnea. in echocardiography the septal leaflet displaced downwardly toward the apex about 8.2 mm and displacement index was 27.3 mm/m2, tricuspid regurgitation (tr) was moderate (vc=5.5mm) with 70 mmhg gradient also an asd with bidirectional shunt and a membranous vsd were seen. catheterisation and angiography was done, pulmonary arterial pressure was subsystemic and a 2.5 mm size pda was seen, in the levophase a medium size vsd was seen. the patient is under follow up with lanoxin, captopril and lasix now. as mentioned earlier epstein’s anomaly is rare and it prevalence is about 0.5% of chds although 50% of patients with ds have chd but its association with epstein’s anomaly is very rare.