If you have Mitral Valve Prolapse you no longer need to take antibiotics before your dental visit!
November 23, 2007 by Dr. Soram Khalsa
Filed under Integrative Medicine
The American Heart Association has just released new guidelines for patients with Mitral Valve Prolapse.
With rare exception, taking antibiotics before your dental appointment or your surgical procedure is no longer required!
The rare exception would be somebody with severe mitral valve prolapse with significant mitral valve regurgitation. The few of you in my practice who have this are aware of who you are.
Things have come so far in the last 40 years with the issue of antibiotics in Mitral Valve prolapse patients. In 1970 it was two days of antibiotics before the dentist. About 1980 it was just one dose before and one dose after the dentist. Then about 1990 it reduced to one dose ONLY before the dentist, and now this good news of NO antibiotics before Dental work is most welcome by me and all my patients!
Prevention of Infective Endocarditis. Guidelines From the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group.Prevention of Infective Endocarditis. Guidelines From the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54. Epub 2007 Apr) 19.])
In Cardiac Tests You Can Now Have Your Cake and Eat It, Too!
November 23, 2007 by Dr. Soram Khalsa
Filed under Integrative Medicine
From the previous article that I wrote on the coronary CT Angiogram, most all my patients now know that this has been the definitive test for screening for coronary artery disease, the most common cause of death in men and women in our country.
Many of my patients have done this test (as have I), and over the last year, over a dozen of my patients have had cardiac interventions to prevent heart attacks because of the information from this test.
A few things have held patients back from getting this test. The first understandable reservation was about the amount of radiation given on the coronary CT Angiogram. It has been equal to approximately 50 current chest X-rays.
The other consideration holding people back, understandably, was the cost, which is $1500.
I am happy to let everybody know that now through major technology improvements both Cedars Sinai Hospital and Cardiovascular Medical Group (CVMG ) have been able to drop the radiation dose by up to 90 per cent!
Below I have a summary of estimated radiation doses for the new vs. the old cardiac imaging studies which Dr. Daniel Berman and I put together.
You can see that the amount of radiation with the new low dose coronary CT Angiogram is now approximately the same as a simple CT coronary calcium scan (also known as EBCT)!
To me this is very exciting news as previously wanting to avoid the large dose of radiation with a CT Angiogram, we have been doing the simple CT coronary calcium scan (EBCT). But because this only shows calcified plaque on the wall of the arteries, we have also had to do a treadmill test to make sure there is not an extreme amount of soft plaque which will be missed by the simple EBCT.
