Page 35 - Clinical Pearls in Cardiology

History and General Examination 23

(i.e. Trisomy 21). The facies and extremities in Down’s
syndrome are characterized by the following typical
features (Fig. 11):
Morphological features of Down’s syndrome
• Flattened occiput and a disproportionately small
head (brachycephalic)
• Epicanthic folds
• Upslanting palpebral fissures
• Flat nasal bridge
• Low set small ears
• Large, protruding and furrowed tongue
• Abnormal teeth
• Short broad hands
• Simian or the transverse palmar crease
• Fourth and fifth fingers are abnormally separated
• Fifth finger is short and curved inward
• Space between the first and second toes (sandal gap
deformity)

Fig. 11: Down’s syndrome

The most common cardiac abnormalities seen in
Down’s syndrome are various combinations of ostium