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Question answered:15/02/08
A 2004 document "Dental Aspects of Endocarditis Prophylaxis" [1] is a set of recommendations from a Working Group of the British Cardiac Society Clinical Practice Committee and Royal College of Physicians Clinical Effectiveness and Evaluation Unit. This lists a number of conditions based on risk, in the case of mitral valve problems it reports:
High risk - Mitral valve prolapse with clinically significant mitral regurgitation or thickened valve leaflets
NOTE: Mitral regurgitation should be obvious clinically or judged by a cardiologist to be more than physiological on Doppler echocardiography
Low risk - Mitral valve prolapse without regurgitation
It later reports:
“When assessing a patient for dental treatment the medical history will reveal the existence of a cardiac problem. The above table should be consulted to determine the cardiac risk category of the patient. For example, the patient may report that he/she has mitral valve prolapse with mitral regurgitation. It is clear that the patient is in the High Risk group and that antibiotic prophylaxis against IE is required for any bacteraemia inducing procedures.”
The guideline, URL below, defines bacteraemia inducing procedures.
In 2004 The Task Force on Infective Endocarditis of the European Society of Cardiology published ‘Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis’ [2]. This mentions mitral valve problems in a number of places. This includes referring to “Mitral valve prolapse with valvular regurgitation or severe valve thickening” as being “Cardiac conditions in which antimicrobial prophylaxis is indicated”.
References
1) http://www.rcseng.ac.uk/fds/docs/ie_recs.pdf
2) http://eurheartj.oxfordjournals.org/cgi/reprint/25/3/267
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