Medical Precautions for Mitral Valvular Regurgitation

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Medical Precautions for Mitral Valvular Regurgitation

Question:

I have mild mitral valvular regurgitation. I am going to have a colonoscopy done next week. What precautions should I take before the colonoscopy? Also, do I need to take antibiotics before a dental procedure, even teeth cleaning?

Answer:

Two years ago, most doctors and I would have recommended antibiotics before these procedures for you — but now, we would not.

Guidelines from the American Heart Association were revised in 2007. Antibiotics before dental work or gastrointestinal procedures are now only recommended for people who have the greatest risk for endocarditis (an infection and inflammation of the heart valves and the inner lining of the heart chambers). This includes people with:

• Artificial heart valves

• Congenital heart disease

• Previous endocarditis

• Heart valve disease following a heart transplant

It doesn't sound like you are in any of these groups.

The reasons for not using antibiotics to prevent endocarditis are:

• The risk of endocarditis for you and most other people is really very low.

• There is some risk of severe allergic reactions from antibiotics.

• The overuse use of antibiotics can lead to bacteria becoming resistant to the drugs

Thomas Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

Last updated:	July 20, 2009