I am a 38 year-old male (non-smoker) who’s always been in
excellent health and physical shape. During my last annual
physical examination in January, my doctor thought my heart
appeared large on a chest x-ray. He suspected it was "athlete’s
heart" but ordered an echocardiograph anyway.
Upon seeing the results of the echocardiograph (which apparently
had been analyzed by a cardiologist, as well) he said that it
revealed what he called a "slight murmur" — mitral valve
regurgitation. I was stunned to hear this and I’m still not sure
I believe it. He said that the MVR was no big deal but, due to
the risk of contracting endocarditis or pericarditis (or whatever
he said it was), from now on I need to pre-medicate with an
antibiotic any and every time I have any dental work (including a
cleaning) or surgery performed!
I have never in my life pre-medicated before having any dental
work done and have no desire to have antibiotics flowing
throughout my system looking for an infection to attack. I’ve
also had a couple of minor surgeries done (removal of sebaceous
cysts) and have never suffered any infections as a result of them.
My questions include 1) is one born with MVR or can it be
acquired?, 2) what is the probability that the echocardiograph (or
the doctor reading it) could have been wrong? (I’ll probably get a
second opinion soon.), 3) what is the probability of a healthy 38
year-old male with MVR contracting a heart infection from a dental
cleaning?, 4) why wouldn’t any minor injury that resulted in
bleeding present the same risk in persons with MVR?, and 5) why
wouldn’t other tissue also be susceptible to infection from a
dental cleaning or minor surgery in persons with MVR?
Getting answers from my doctor is like pulling teeth.
Thank you in advance for your help.
R.
- Hide quoted text — Show quoted text -
>I am a 38 year-old male (non-smoker) who’s always been in
>excellent health and physical shape. During my last annual
>physical examination in January, my doctor thought my heart
>appeared large on a chest x-ray. He suspected it was "athlete’s
>heart" but ordered an echocardiograph anyway.
>I was stunned to hear this and I’m still not sure
>I believe it. He said that the MVR was no big deal but, due to
>the risk of contracting endocarditis or pericarditis (or whatever
>he said it was), from now on I need to pre-medicate with an
>antibiotic any and every time I have any dental work (including a
>cleaning) or surgery performed!
>I have never in my life pre-medicated before having any dental
>work done and have no desire to have antibiotics flowing
>throughout my system looking for an infection to attack.
***RESPONSE:
(miscellaneous denial stuff deleted)
Listen to your cardiologist.
You’re damned lucky to have caught it.
I had an aortic valve replaced 9 years ago that started with mumur.
Showed up on echo as enlarged heart. Otherwise, I’d be long dead.
Now take ampicillin before going to dentist.
And am happy to have the opportunity to do so.
–
-H.W. "Skip" Weldon
Columbia SC USA
h…@ix.netcom.com(HW "Skip" Weldon. ) wrote:
>Listen to your cardiologist.
>You’re damned lucky to have caught it.
>I had an aortic valve replaced 9 years ago that started with mumur.
>Showed up on echo as enlarged heart. Otherwise, I’d be long dead.
>Now take ampicillin before going to dentist.
>And am happy to have the opportunity to do so.
>–
>-H.W. "Skip" Weldon
> Columbia SC USA
I hope you mean Amoxicillin… 3000mg 1 hr before appt. and 1500mg 6
hrs after initial dose. ( that is if you are not allergic to
penicillin)
YDFW
In article <4utchp$…@ns.lij.edu>, Ralph Castro <cas…@lij.edu> wrote:
> My questions include 1) is one born with MVR or can it be
> acquired?, 2) what is the probability that the echocardiograph (or
> the doctor reading it) could have been wrong? (I’ll probably get a
> second opinion soon.), 3) what is the probability of a healthy 38
> year-old male with MVR contracting a heart infection from a dental
> cleaning?, 4) why wouldn’t any minor injury that resulted in
> bleeding present the same risk in persons with MVR?, and 5) why
> wouldn’t other tissue also be susceptible to infection from a
> dental cleaning or minor surgery in persons with MVR?
> Getting answers from my doctor is like pulling teeth.
Hi, Ralph.
I certainly don’t know all the answers to these questions, but a good
background article on endocarditis and antibiotics is available on the
American Heart Association’s web page.
Good luck!
Liz (mom to Campbell, born with transposition of the great arteries, now
16 months old and will always need those antibiotics!)
–
Liz Nilsen
Child Care Careers Institute
Boston, MA
Ralph,
Skip Weldon has given you some excellent advise and an example from
his life. The most common place to find the bacteria that cause
endocarditis is in the mouth. I have read of a couple of patients
that did not take prescribed antibiotics prior to treatment and died
as a result of the endocarditis. You do not need to worry about
resistence to the antibiotic, for it is given in very high doses and
you will take it very infrequently. Thanks, Skip, for sharing your
personal story. Dr. Jeff W.
Ralph,
If you are having difficulty getting answers from your doctor, ask
again! If you doubt his diagnosis, get a second opinion! The risk of
contracting endocarditis is rare even with your condition, however it
can be prevented by using the antibiotics. Endocarditis is serious and
can be fatal. As a patient, I wouldn’t risk it. As a Doctor, I would
refuse to treat you if you did not comply with the antibiotics (no
exeptions!) Most of us dentists have limited training regarding
treatment and etiology of endocarditis (we do know about prevention),
ask your cardiologist about this.
Romboman
In <4utchp$…@ns.lij.edu> Ralph Castro <cas…@lij.edu> writes:
- Hide quoted text — Show quoted text -
>I am a 38 year-old male (non-smoker) who’s always been in
>excellent health and physical shape. During my last annual
>physical examination in January, my doctor thought my heart
>appeared large on a chest x-ray. He suspected it was "athlete’s
>heart" but ordered an echocardiograph anyway.
>Upon seeing the results of the echocardiograph (which apparently
>had been analyzed by a cardiologist, as well) he said that it
>revealed what he called a "slight murmur" — mitral valve
>regurgitation. I was stunned to hear this and I’m still not sure
>I believe it. He said that the MVR was no big deal but, due to
>the risk of contracting endocarditis or pericarditis (or whatever
>he said it was), from now on I need to pre-medicate with an
>antibiotic any and every time I have any dental work (including a
>cleaning) or surgery performed!
>I have never in my life pre-medicated before having any dental
>work done and have no desire to have antibiotics flowing
>throughout my system looking for an infection to attack. I’ve
>also had a couple of minor surgeries done (removal of sebaceous
>cysts) and have never suffered any infections as a result of them.
>My questions include 1) is one born with MVR or can it be
>acquired?, 2) what is the probability that the echocardiograph (or
>the doctor reading it) could have been wrong? (I’ll probably get a
>second opinion soon.), 3) what is the probability of a healthy 38
>year-old male with MVR contracting a heart infection from a dental
>cleaning?, 4) why wouldn’t any minor injury that resulted in
>bleeding present the same risk in persons with MVR?, and 5) why
>wouldn’t other tissue also be susceptible to infection from a
>dental cleaning or minor surgery in persons with MVR?
>Getting answers from my doctor is like pulling teeth.
>Thank you in advance for your help.
>R.
>>Listen to your cardiologist.
>>You’re damned lucky to have caught it.
>>I had an aortic valve replaced 9 years ago that started with mumur.
>>Showed up on echo as enlarged heart. Otherwise, I’d be long dead.
>>Now take ampicillin before going to dentist.
>>And am happy to have the opportunity to do so.
>I hope you mean Amoxicillin… 3000mg 1 hr before appt. and 1500mg 6
>hrs after initial dose. ( that is if you are not allergic to
>penicillin)
And now you know why I need my cardiologist. <grin>
—
-H.W. "Skip" Weldon
Columbia SC USA
Ralph Castro <cas…@lij.edu> wrote:
>I am a 38 year-old male <SNIP>
>I have never in my life pre-medicated before having any dental
>work done and have no desire to have antibiotics flowing
>throughout my system looking for an infection to attack.
The alternative is having bacteria flowing throughout your system
looking for a diseased heart valve to attack!
>I’ve
>also had a couple of minor surgeries done (removal of sebaceous
>cysts) and have never suffered any infections as a result of them.
Most minor surgery is done on pretty clean tissue and doesn’t result
in bacteraemia. Oral and bowel procedures are another matter.
>My questions include 1) is one born with MVR or can it be
>acquired?,
Acquired
>2) what is the probability that the echocardiograph (or
>the doctor reading it) could have been wrong? (I’ll probably get a
>second opinion soon.)
Hard to answer objectively. Get a seciond echo if you wish. There’ll
always be a possibility of error.
>3) what is the probability of a healthy 38
>year-old male with MVR contracting a heart infection from a dental
>cleaning?
Very important question, to which I don’t know the answer. How many
healthy 38 year-old males with known MVR undergo dental cleaning
without antibiotic cover? And what risk would you consider acceptable,
anyway? 5%? 10%? 1%?
>4) why wouldn’t any minor injury that resulted in
>bleeding present the same risk in persons with MVR?,
It’s to do with the number and type of germs on the traumatised
surface; also, in accidental injury there isn’t a way of preventing
the risk as the accidents are unpredictable. With dental procedures
etc the events are entirely predictable. Doctors are good at coping
with poor outcomes from unpredictable events, but sleep very poorly if
someone has a poor outcome that could have been easily avoided.
>5) why
>wouldn’t other tissue also be susceptible to infection from a
>dental cleaning or minor surgery in persons with MVR?
Damaged tissues are more susceptible to infection; your heart valve is
presumed to be damaged.
>Getting answers from my doctor is like pulling teeth.
Then you ought to take some amoxicillin before you see him/her
>Thank you in advance for your help.
This may have given you more questions than answers.
Michael
Ralph Castro writes:
>I am a 38 year-old male (non-smoker) who’s always been in
>excellent health and physical shape. During my last annual
>physical examination in January, my doctor thought my heart
>appeared large on a chest x-ray. He suspected it was "athlete’s
>heart" but ordered an echocardiograph anyway.
>Upon seeing the results of the echocardiograph (which apparently
>had been analyzed by a cardiologist, as well) he said that it
>revealed what he called a "slight murmur" — mitral valve
>regurgitation. I was stunned to hear this and I’m still not sure
>I believe it. He said that the MVR was no big deal but, due to
>the risk of contracting endocarditis ….
—————————
You raise many difficult-to-answer questions. Two points:
1. Was the "enlarged heart" confirmed on the echo? If not, and the MVR
was only trivial-mild, this could well be regarded as within normal limits, and
antibiotics would not be appropriate.
If yes, then you have a further problem to be concerned about. A cardiologist’s
opinion is probably needed to clear up both issues.
Unfortunately there is a tendency for tests (and echos in particular) to reveal
minor variations in structure & function that everyone would be better off
remaining unaware of.
2. The frequency of valve infections in hearts with isolated minor valve
leakages is not known, but is obviously not common. This is the denominator
of an expression for which cardiologists mostly see the numerator — those people
(and there are a lot of them) who present with serious valve infections having
had dental work where an abnormal valve was unprotected by antibiotics at the
time of dental work or other procedures where bacteria usually invade the
bloodstream.
There has been a great deal of discussion and argument about this, but
the fact remains that taking 1 or 2 doses of an antibiotic is a small
premium to insure against the risk of a potentially fatal (and certainly highly
inconvenient and prolonged) infection. From the point of view of the physician
& dentist, antibiotic prophylaxis for significantly abnormal or variant valves
is regarded as sufficiently scientifically based to guarantee an instant
indefensible lawsuit should endocarditis occur when it has been omitted.
David Rollo
HW Skip Weldon. wrote:
[snip]
- Hide quoted text — Show quoted text -
> >I was stunned to hear this and I’m still not sure
> >I believe it. He said that the MVR was no big deal but, due to
> >the risk of contracting endocarditis or pericarditis (or whatever
> >he said it was), from now on I need to pre-medicate with an
> >antibiotic any and every time I have any dental work (including a
> >cleaning) or surgery performed!
> >I have never in my life pre-medicated before having any dental
> >work done and have no desire to have antibiotics flowing
> >throughout my system looking for an infection to attack.
[snip]
> Listen to your cardiologist.
> You’re damned lucky to have caught it.
> I had an aortic valve replaced 9 years ago that started with mumur.
> Showed up on echo as enlarged heart. Otherwise, I’d be long dead.
> Now take ampicillin before going to dentist.
> And am happy to have the opportunity to do so.
Well said! I’ve lived with a heart murmur my whole life from surgery I
had as a toddler. About 5 years ago, my new dentist told me I should
premedicate with amoxicillin (an antibiotic). My old dentist never told
me to, but once I learned about the risk, I wish he would have. My
family physician now tells me that if I were to even cut myself severely
enough with a kitchen knife, say, I should take some amoxicillin to be
safe. Endocarditis and myocarditis are pretty nasty things that may
permanently damage your heart. They may also not develop until well
after your visit to the dentist. If you think antibiotics for a teeth
cleaning is overkill, remember that your mouth is one of the most
bacteria filled parts of your body. If the wrong bacteria gets into
your blood stream and makes it to your heart, you’re in serious trouble.
And it’s certainly much better to have antibiotics flowing throughout
your system than a couple of rogue bacteria. I’m no doctor, but I’d
suggest listing to your doctor, take the half-dozen pills of antibiotics
before your visit to the dentist, and be thankful that someone caught
it.
"Haris J. Sih" <s…@engr.iupui.edu> wrote:
>Well said! I’ve lived with a heart murmur my whole life from surgery I
>had as a toddler. About 5 years ago, my new dentist told me I should
>premedicate with amoxicillin (an antibiotic). My old dentist never told
>me to, but once I learned about the risk, I wish he would have. My
>family physician now tells me that if I were to even cut myself severely
>enough with a kitchen knife, say, I should take some amoxicillin to be
>safe.
(snip)
> If you think antibiotics for a teeth
>cleaning is overkill, remember that your mouth is one of the most
>bacteria filled parts of your body. If the wrong bacteria gets into
>your blood stream and makes it to your heart, you’re in serious trouble.
>And it’s certainly much better to have antibiotics flowing throughout
>your system than a couple of rogue bacteria. I’m no doctor, but I’d
>suggest listing to your doctor, take the half-dozen pills of antibiotics
>before your visit to the dentist, and be thankful that someone caught
>it.
Whoa, wait a minute! How old are you? You’ve had the heart
murmur since you were a toddler and lived your whole life up
until five years ago, presumably having had a few dental
cleanings and occasional minor injuries along the way, without
pre-medicating. Now, just because some dentist told you about
the potential risk, you pre-medicate before all dental work?
With all due respect, it’s going to take a hell of a lot more
than your or some other doctor’s or dentist’s opinion on this
before I’m convinced that it’s not overkill or downright
unecessary. How about some data on the risks?
R.
Well it appears Ralph you have recieved a large amount of attention to
your questions!
Let me share a story with you all,
Once upon a time
I was diagnosed with IHSS at age 12 and told I was fine. IHSS, Now
referred to as Hypertorphic cardiomyopathy, is a heart muscle disease, it
also caused mitral valve regugitation in my case. HCM runs in my family, I
lost my sister last year to HCM. HCM can be misread easily as "athletes
heart" and the murmur HCM can cause dismissed by some doctors as minor. I
do not say this to fault any physician, HCM is a very complex and
difficult condition.
When I was 21 years old, 2 days before my wedding I went to the dentist.
). My dentist had
I was in a lot of pain and wanted it treated before I was married. (a
tooth ache could really have ruined my honeymoon
told me years ealier Premedication was not needed in my case, because it
was genetic?.?.??
Well I am sure you have guessed by now….. 3 weeks after my wedding I was
hospitalized. I had had a stroke! 21 years old, just married, and I had
a stroke!?!?!?!?!?
Why did I have a stroke you may wonder. It was secondary to SBE
ENDOCARDITIS, a small piece of the bacteria broke off and set in my brain!
I was paralized for several weeks, underwent 6 weeks of IV antibiotics
(NOT IN MY ARM, I needed a Hickman Cath. THEY but the line directly into
my chest!!, I have the scars to prove it!)
That was several years ago. I am happy to say I have made a good
recovery. my mitral valve is damaged and is fine for now. If I ever get
SBE again I will most likely need a new valve!
If I have not made myself clear, TAKE YOUR PREMEDICATION!!!!!
I went through HELL! AVIOD IT AT ALLLLLLLLLL CCCCOOOOSSSTTTSSSS!
Well, that ends my story, I hope it has helped.
I would recommend a second opinion in your diagnosis, it sounds like a
possible HCM. Check out my Web site for more information!
http://www.kanter.com/hcm/
Wishing you good health!
Lisa Salberg
Founder HCMA
LFAS1…@aol.com Lisa Salberg
dro…@cns.net.au wrote:
>You raise many difficult-to-answer questions. Two points:
>1. Was the "enlarged heart" confirmed on the echo? If not, and the MVR
>was only trivial-mild, this could well be regarded as within normal limits, and
Would you beleive that my physician, that veritable fountain of
information, didn’t tell me? Would you also believe that I,
stupid moron that I am, didn’t think to ask?
>If yes, then you have a further problem to be concerned about. A cardiologist’s
>opinion is probably needed to clear up both issues.
>Unfortunately there is a tendency for tests (and echos in particular) to reveal
>minor variations in structure & function that everyone would be better off
>remaining unaware of.
Maybe I’ll go see another cardiologist soon.
>There has been a great deal of discussion and argument about this, but
>the fact remains that taking 1 or 2 doses of an antibiotic is a small
>premium to insure against the risk of a potentially fatal (and certainly highly
>inconvenient and prolonged) infection.
Fair enough.
> From the point of view of the physician
>& dentist, antibiotic prophylaxis for significantly abnormal or variant valves
>is regarded as sufficiently scientifically based to guarantee an instant
>indefensible lawsuit should endocarditis occur when it has been omitted.
Don’t get me started on malpractice law suits!
Thanks for all the info.
R.
Ralph Castro <cas…@lij.edu> wrote:
>My questions include 1) is one born with MVR or can it be
>acquired?, 2) what is the probability that the echocardiograph (or
>the doctor reading it) could have been wrong? (I’ll probably get a
>second opinion soon.), 3) what is the probability of a healthy 38
>year-old male with MVR contracting a heart infection from a dental
>cleaning?, 4) why wouldn’t any minor injury that resulted in
>bleeding present the same risk in persons with MVR?, and 5) why
>wouldn’t other tissue also be susceptible to infection from a
>dental cleaning or minor surgery in persons with MVR?
>Getting answers from my doctor is like pulling teeth.
>R.
If your physician can’t give you the answers you need, you need another
physician. Based on the limited information you have given, let me try
to very briefly answer your questions: MR can be acquired under
numerous circumstances; one can also be born with it. It would be
unusual to misdiagnose MR on an echo, although the severity could be
mis-calculated—usually underestimated on a transthoracic study. The
probability of contracting endocarditis really depends on the etiology of
the MR; some types are worse than others. Dental work (or colonoscopy,
etc.) poses a larger risk because of the bacteria that reside in the
mouth (or colon, etc.), and because of the risk of "seeding" the blood
with bacteria. The valve tissue is more susceptible because it is
presumably abnormal (whether scarred, or redundant, or malformed) and
because of the turbulent blood flow through the orifice, which assists
the bacteria in "sticking to" or seeding the valve. Please either talk
this over with your M.D., or get a second opnion—endocarditis can be
life-threatening. A., Fellow, Creighton Cardiac Center
Ralph Castro <cas…@lij.edu> wrote:
>Isn’t there always some bacteria in the bloodstream?
There are occasional SMALL showers of bacteria (after straining at
stool or brushing teeth, for example), but people with smooth
endovascular surfaces, no foreign bodies, and normal immune competence
can clear these out. People with vascular oxbows and backwaters
(e.g., people with heart valves abnormal enough to be noisy), are not
so resistant, especially to the BIG showers of bacteria that sometimes
accompany dental work.
:
: > From the point of view of the physician
: >& dentist, antibiotic prophylaxis for significantly abnormal or variant valves
: >is regarded as sufficiently scientifically based to guarantee an instant
: >indefensible lawsuit should endocarditis occur when it has been omitted.
: : Don’t get me started on malpractice law suits!
Is the patient being treated, or is the DDS’s fear of malpractice
being treated?
Joan
- Hide quoted text — Show quoted text -
> I have never in my life pre-medicated before having any dental
> work done and have no desire to have antibiotics flowing
> throughout my system looking for an infection to attack. I’ve
> also had a couple of minor surgeries done (removal of sebaceous
> cysts) and have never suffered any infections as a result of them.
> My questions include 1) is one born with MVR or can it be
> acquired?, 2) what is the probability that the echocardiograph (or
> the doctor reading it) could have been wrong? (I’ll probably get a
> second opinion soon.), 3) what is the probability of a healthy 38
> year-old male with MVR contracting a heart infection from a dental
> cleaning?, 4) why wouldn’t any minor injury that resulted in
> bleeding present the same risk in persons with MVR?, and 5) why
> wouldn’t other tissue also be susceptible to infection from a
> dental cleaning or minor surgery in persons with MVR?
> Getting answers from my doctor is like pulling teeth.
> Thank you in advance for your help.
> R.
I am a 62 year old woman just diagnosed with MVP by echocardiography-
though I had one 4 years ago that was normal, revealed no prolapse. The
MVP is considered to be mild, to at most, moderate. I know this question
sounds a little uniformed, but I have had a lot of dental work,
gingivectomy, an extraction, in the past year before diagnosis without
antibiotic. Is it possible to get endocarditis and not know it? There were
never any signs of infection. Also, can one get MVP from a bad cold, from
flu? In other words, how is it acquired. This whole thread is interesting
to me; I have been told for20 years that I had "athlete’s heart," although
the echo showed it to be of normal size.
Is the patient being treated, or is the DDS’s fear of malpractice
being treated?
Joan
Dear Joan,
What is your problem!?!?!?!?!? SBE is a serious condition. It almost
killed me at age 21!!!!! Your attitude is amazing. If this were not the
internet and I not a lady I would tell you in more explicit terms just how
sick your statement makes me.
You need to be educated before you make statements that strong.
Sincerely,
Lisa Salberg
Founder HCMA
LFAS1…@aol.com Lisa Salberg
Ralph Castro <cas…@lij.edu> wrote:
>(snip)
>….. Now, just because some dentist told you about
>the potential risk, you pre-medicate before all dental work?
>With all due respect, it’s going to take a hell of a lot more
>than your or some other doctor’s or dentist’s opinion on this
>before I’m convinced that it’s not overkill or downright
>unecessary. How about some data on the risks?
>R.
Dear Ralph,
It seems like you have made up your mind regarding this problem before
asking the news group. I don’t understand your motives. You asked for
help, people gave you sufficient answers. Now you say you don’t
believe it and you want data. Well sir, it’s not our job to give you
research data, THAT’S YOUR JOB. Do your home work, go to a local
library or the nearest medical school library and look up the problem.
If you don’t believe your dentist or MD, then you need to do your own
research.
I did not answer before because you touched on a nerve for me. I just
lost a very close uncle to bacterial endocarditis. He was 44 with 4
kids, all still in school. You see, a wise man once said:
It’s little knowledge that will kill you. You’d be safe with none or
a lot of knowledge. (Translated from another language, that’s why it
sounds weird, but you get the drift, don’t you).
So please wise up and listen to your doctors, if not for yourself, do
it for your family. Taking a few pills to avoid a tragedy is a minor
inconvenience.
Again, please go to a library (or even on the NET) and do your own
research.
Best regards and good luck,
YDFW
In article <4uv7hv$…@perki0.connect.com.au>, dro…@cns.net.au writes:
[Big snip...]
>There has been a great deal of discussion and argument about this, but
>the fact remains that taking 1 or 2 doses of an antibiotic is a small
>premium to insure against the risk of a potentially fatal (and certainly highly
>inconvenient and prolonged) infection. From the point of view of the physician
>& dentist, antibiotic prophylaxis for significantly abnormal or variant valves
>is regarded as sufficiently scientifically based to guarantee an instant
>indefensible lawsuit should endocarditis occur when it has been omitted.
>David Rollo
Is this subacute bacterial endocarditis that’s being discussed here?
If so, I can’t locate any journal articles tieing this in with
dentistry. Anyone with a reference to JADA?
I would like to know about the meaning of the phrase "significantly
abnormal or variant valves". It would seem that we would be
referring to the mechanical action of the valve as it opens and
closes (murmer?), not the rate at which it operates (arrhythmia?)?
Mark gmt1…@msu.oscs.montana.edu msu-bozeman USA
Mitral valve prolapse is really a subset of mitral regurgitation—the
leaflets of the mitral valve flex back into the left atrium during
ventricular systole and can produce regurgitation, usually in small
amounts. Most people who have MVP are born with it (although this may be
a bit of an over-generalization) and have a varying degree of redundancy
of valve structure. Mitral valve prolapse tends to come and go, based on
loading conditions (fluid levels in the body), stress levels, caffeine
intake, etc., which could be why it wasn’t seen on the echo 4 years ago.
(And sometimes a physician can hear the MVP on ascultation but then will
not see it on echo.) Most cardiologists around here don’t prophylax
patients with pure MVP with antibiotics prior to procedures such as
dental work, although I would speak with your own M.D., who knows your
particular case.
If you had endocarditis, you would know it. You would be quite ill and
would probably see your physician due to numerous nonspecific
symptoms—including fevers, night sweats, lethargy, shortness of breath,
maybe a "rash", edema, etc., etc. The last patient I saw had these
symptoms for a month (he was pretty stoic), but he’s doing well now after
a valve replacement.
To name just a couple of examples of how mitral regurgitation (not mitral
valve prolapse) is acquired: MR might be acquired if the left ventricle
enlarges, as with remodelling after a heart attack or with a
cardiomyopathy; alternatively, the chords which tether the valve can
break after years of wear and tear; or the muscles that attach to the
chords can malfunction with ischemia or after a heart attack.
Hope this helps. A., Fellow, Creighton Cardiac Center
- Hide quoted text — Show quoted text -
>I am a 62 year old woman just diagnosed with MVP by echocardiography-
>though I had one 4 years ago that was normal, revealed no prolapse. The
>MVP is considered to be mild, to at most, moderate. I know this question
>sounds a little uniformed, but I have had a lot of dental work,
>gingivectomy, an extraction, in the past year before diagnosis without
>antibiotic. Is it possible to get endocarditis and not know it? There were
>never any signs of infection. Also, can one get MVP from a bad cold, from
>flu? In other words, how is it acquired. This whole thread is interesting
>to me; I have been told for20 years that I had "athlete’s heart," although
>the echo showed it to be of normal size.
> I am a 62 year old woman just diagnosed with MVP by echocardiography-
> though I had one 4 years ago that was normal, revealed no prolapse. The
> MVP is considered to be mild, to at most, moderate. I know this question
> sounds a little uniformed, but I have had a lot of dental work,
> gingivectomy, an extraction, in the past year before diagnosis without
> antibiotic. Is it possible to get endocarditis and not know it? There were
> never any signs of infection. Also, can one get MVP from a bad cold, from
> flu? In other words, how is it acquired. This whole thread is interesting
> to me; I have been told for20 years that I had "athlete’s heart," although
> the echo showed it to be of normal size.
I don’t think you can get endocarditis and not know it. As I said in an
earlier message, my husband has had 4 bouts of it since 1983 and is
currently recouperating from a mitral valve replacement.
His symptoms started like flu; general achy feelings, lethargy, then fever
that spikes up to 103 or more, then when you take it 20 minutes later it’s
normal, then back up. First time he had it we threw away good therm.
because we thought it was bad. Thank God our family dr. at that time had
been reading recently about endocarditis and his brain sent up a flag when
I showed him my chart of temps over a 12 hour period.
Barb
–
Barb Wilkison
wilk…@citizen.infi.net
> Getting answers from my doctor is like pulling teeth.
> Thank you in advance for your help.
> R.
Ralph…Listen to your dentist!!!! My husband is currently in the
hospital, had his mitral valve replaced last Wednesday. Since 1983 he has
had 4 occurrances of bacterial endocarditis. It’s been a year getting this
last one under control. Each time it gets more resistant to antibiotics.
Each time he’s gotten it has been within several months of dental work.
First time he didn’t know about the pre-medication recommendations. The
more recent times he medicated heavily both before and after, but got it
anyway. His system just couldn’t fight it off. He can’t remember and he’s
adopted and birth parents are deceased, but doctors seem to think he must
have had rheumatic fever as a young child. He had valve prolapse, then
regurgitation kept getting worse. Endocarditis kept attacking the valve
and finally damaged it beyond repair. Save yourself trouble and possibly
your life…take the meds!
Barb
–
Barb Wilkison
wilk…@citizen.infi.net