Atrioventricular septal defect in a 31 year old female

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A 31 year old woman was found on the floor of her home by her parents. She was dark blue in color with no pulse. CPR was initiated, and she recovered in a few minutes. In the emergency department, she complained only of chest pain at sternum.

She was born with Down's Syndrome and a complete atrioventricular septal defect. She had congestive heart failure in infancy but not subsequently. By age of 5 she demonstrated cyanosis and clubbing. In the past years she has had several episodes of syncope. She has had symptoms of hyperviscosity in the past treated with phlebotomy. She takes digoxin, iron sulfate 325 mg/d, and lasix.

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