Factors associated with the recommendation for endocarditis prophylaxis in mitral valve prolapse

Article Abstract:

The heart's mitral valve, a structure between the left atrium and left ventricle, functions to direct blood flow from the atrium to the ventricle during contraction of the heart. Mitral valve prolapse, MVP, is a condition in which the mitral valve bulges into the left atrium resulting in impaired blood flow, abnormal heart sounds, and other signs and symptoms including chest pain, fatigue and palpitations. Individuals with MVP are often prescribed antibiotics when they undergo certain procedures to prevent infection (prophylactic therapy) because they are considered to be at risk for endocarditis, inflammation of the membranes lining the heart valve. For example, a person with MVP takes penicillin or another antibiotic prior to and following dental examinations to prevent bacteria in the mouth from causing infectious endocarditis (IE). In this case, the antibiotic is considered to be endocarditis prophylaxis. Previous research suggests that individuals with MVP are five times more likely to develop IE. This study examined the factors that were associated with the use of endocarditis prophylaxis in 127 individuals with MVP who resided in Olmsted County, Minnesota. Prophylactic therapy was recommended three to four times more often in patients under 40 years compared to those more than 60 years. For every ten year increase in age, there was a 30 percent reduction in the recommendation for endocarditis prophylaxis. Results of echocardiography, the use of sound waves to visualize the heart, and physical examination were criteria supporting physicians' recommendations for treatment. However, the actual appearance of the prolapsed mitral valve did not influence the decision to use endocarditis prophylaxis. Further investigation is required to determine the risk factors for infectious endocarditis in individuals with MVP.

author: Lavie, Carl J., Khandheria, Bijoy K., Seward, James B., Tajik, A. Jamil, Taylor, Catherine L., Ballard, David J.
Prevention, Complications and side effects, Risk factors, Mitral valve prolapse, Endocarditis

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Clinical outcome of mitral regurgitation due to flail leaflet

Article Abstract:

Patients with mitral regurgitation due to flail leaflet should be offered surgery even if they are asymptomatic. This heart condition occurs when blood leaks back into the heart during contraction because the valve does not close properly. Researchers found that 86 patients with this condition who were only treated with drugs had death rates higher than in the general population. Even those with few symptoms had a high death rate. Within 10 years of their diagnosis, many of the patients either died or required surgery. Surgery significantly reduced the mortality rate in these patients.

author: Frye, Robert L., Bailey, Kent R., Seward, James B., Tajik, A. Jamil, Enriquez-Sarano, Maurice, Schaff, Hartzell V., Ling, Lieng H.
Abnormalities, Mitral valve

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Quantitative determinants of the outcome of asymptomatic mitral regurgitation

Article Abstract:

Effect on the outcome of quantifying mitral regurgitation was studied. The studies indicated that the clinical outcome of asymptomatic mitral regurgitation could be predicated by quantitative grading of mitral regurgitation.

author: Tajik, A. Jamil, Enriquez-Sarano, Maurice, Messika-Zeitoun, David, Capps, Maryann, Scott, Christopher, Avierinos, Jean-Francois, Detaint, Delphine, Nkomo, Vuyisile, Schaff, Hartzell V.
United Kingdom, Patient outcomes, Heart diseases

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subjects list: Care and treatment, Mitral valve insufficiency
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