9th May 2025

An 18-year-old female presents to her GP due to increased shortness of breath.

An 18-year-old female presents to her GP due to increased shortness of breath. She attends with her mother, who assists her with all activities of daily living. She reports that they have moved frequently throughout her childhood, so she has not had any further follow-up regarding her diagnosis of Down’s syndrome for several years. 

On examination, she looks comfortable at rest. There is a holosystolic murmur on auscultation and mild pitting oedema to both knees. Her ECG in the clinic shows signs of slight left ventricular hypertrophy. 

Given the likely underlying congenital cardiac defect, what is the most appropriate management for this lady?

Select the SINGLE most appropriate option from the list below. Select ONE option only.