How to avoid endocarditis?

[Johan]

I am now nearly 4 months post AVR with a bovine tissue valve, and doing great. In cardio rehab etc. I was wondering, is endocarditis more prevalent with tissue valves and how does one actually contract it? I am aware of the dental story and the controversy about needing prophylatic antibiotics or not. Are there other causes such as the small sore on my leg which remains red and inflamed after a week in spite of antiseptic creams. (bumped leg against old engine block). Is this the sort of thing one should be worried about? Johan

 

[Lynlw]

I believe I've read only about 1/3 or 1/2 of the cases of BE can be tracked back to dental and the rest they aren't sure. and Honestly I hate to say this, but it seems to be to ME at least just a matter of luck. Justin got his when he was 11 a couple weeks after losing one of the bigger baby teeth which happen to like 1 in a million. The best you can do is good oral hygene. I've personally never heard of anyone getting it from a small sore, especialy if you are taking care of it, but anything that gets bacteria into your blood stream can cause it.

 

[Lionheart]

Johan,
I don't know about the potential for endocarditis, but if your injury is not healling then you should have it checked out to prevent infection. You may need a tetanus shot and maybe antibiotics to prevent a basic infection.
Take care,
John

 

[sue943]

Mine was due to having treatment for kidney stones. As Lynn said, it is almost a matter of luck. After having my valves replaced I had constantly bleeding gums and 'deep pockets' which went on for a couple of years until treated, one would have expected possible problems but I didn't get it again despite those who have had it once being high risk.

 

[Equusz]

Hi:

I recently contacted Dr. Kathryn Taubert, one of authors of the AHA's newest study on endocarditis risk and antibiotics. I wanted definitive info for one of my nursing exams because my older textbook wasn't reflecting the newest approach:

Those people at highest risk include those with:

· Prosthetic cardiac valve or prosthetic material used for cardiac valve repair

· Previous endocarditis

· Congenital heart disease for these conditions:
– Unrepaired cyanotic congenital heart disease, including palliative shunts and conduits

– Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure†
– Repaired congenital heart disease with residual defects (persisting leaks or abnormal flow) at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)

· Cardiac transplantation recipients who develop cardiac valve abnormalities

There is more discussion on our website at: http://www.heart.org/presenter.jhtml?identifier=4436 (there is also a link to the endocarditis wallet card on this webpage.

The 2007 scientific statement on prevention of infective endocarditis is on the web at

http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.183095

I hope this info has been helpful. Thanks for contacting us.

KT

Kathryn A. Taubert, PhD, FAHA
Senior Scientist
American Heart Association
National Center

Hope this helps.

--Equusz

 

[Johan]

Thank you Lyn, John, Sue and Equusz for your prompt replies. I quess it is the luck of the draw in a sense. I checked out the article on endocarditis you recommended Equusz but will probably still take my antibiotics in future dental work as a belt and braces move!
Thanks, I am not so worried about the sore anymore but will get it checked out tomorrow if still infected, normally I do not have problems with nicks and cuts. Johan

 

[Trinityheart8891]

Johan,
I'm a congenital heart patient, my cardiologist doesnt reccomend dental antibiotics for me (I used to take them, but with the new guidelines I'm not reccomended to and I dont, and I agree with the new guidelines, they are based in evidence based medicine, the old guidelines were more for just being over cautious, they werent based on any scientific evidence, and now we are having issues with antibiotic resistance running rampant) but he did suggest being careful about cuts and scrapes, making sure they were clean and watching them, as well as watching out for fevers of unknown origin, being careful when I am sick with normal stuff like colds/flus and stuff

hope this helps

 

[dl_mooney]

Believe my Surgeon said 90% of heart infections are from ones mouth.Dental cleaning a few days ago did take the ordered 2000Mgs of Ampicillin.Sure want to stay away from any valve infection...