• Precocious pulmonary hypertension in children with Down's syndrome may occur in patients with or without congenital heart disease. Chronic upper airway obstruction, which is common in Down's syndrome, is a well-recognized stimulus of elevated pulmonary artery pressure and may explain the propensity for idiopathic pulmonary hypertension or accelerated pulmonary vascular changes with left-to-right shunts in these children.
(Am J Dis Child 1981;135:1050-1052)