<prompt> In a Downs syndrome patient posted for surgery, the necessary pre-operative investigation to be done is ?CT BrainEchocardiographyUltrasound AbdomenX-Ray cervical spine  <response>: B i.e. Echocardiography Congenital hea disease especially endocardial cuchion defects is frequently found in Downs syndrome children.Echocardiography is therefore considered a necessary pre-operative investigation. 