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Re: Mitral Valve Prolapse From: Harvey S. Marchbein, M.D. (hmarchbein@worldnet.att.net) Wed May 28 09:27:38 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Pravin Kini: "Fibroid management with Gnrh agnoist" Previous message: Gibbons, John: "Re:Date: Wed, 28 May 1997 10:39:39 -0400" In reply to: DoctorJoe@aol.com: "Re: Mitral Valve Prolapse" Next in thread: Garry E. Siegel, M.D.: "Re: Mitral Valve Prolapse" Reply: Garry E. Siegel, M.D.: "Re: Mitral Valve Prolapse" At Wed, 28 May 1997, DoctorJoe@aol.com wrote: > ><<>Over here to the indications for antibiotic prohylaxis are: >>1 Women with mechanical valve replacements >>2 Women with past history of endocarditis. > >-- >>Malcolm Griffiths > >We add patients who are symptomatic with MVP and patients with mitral >regurgitation. > >-- >Harvey>> > >As I understand the theory behind it, a purist would give prophylaxis to >anyone with a significant MURMUR, but not simply a CLICK alone. Supposedly >it's the turbulence of the blood flow which causes a relative area of low >pressure that is somewhat "protected" from the body's immune system, allowing >for bacteria to settle out and grow without disturbance. In theory, I agree. But in practical terms, those in which an increased chance of SBE exists, the ?American Heart Association about January1991 (sorry, Bob, I don't have the reference. I'm on vacation!) recommended no prophylaxis for ob-gyn procedures unless antibiotics would be used without the diagnosis of MVP, e.g. infection, temperature elevation, prolonged labor. It is the opinion of the cardiologists in our geographic area that mitral regurgitation indicates a greater functional abnormality of the valve, increasing the likelihood of infection. Similarly, symptomatology is more likely to be related to greater functional abnormality of the valve and therefore, these two criteria will increase the risk of SBE (although the MR is considered much more of a risk than the symptom expression). -- Harvey Harvel the Marvel Harvey S. Marchbein, M.D. FACOG, FACS President, Nassau Obstetrical and Gynecological Society, Inc. OBGYN.net U.S. Representative, New York http://www.obgyn.net/states/bios/marchbein.htm Private practice, Long Island, N.Y. ********************************* It's better to be lucky than to be smart. Even smart people can have an off day! ********************************* Next message: Dr. Pravin Kini: "Fibroid management with Gnrh agnoist" Previous message: Gibbons, John: "Re:Date: Wed, 28 May 1997 10:39:39 -0400" In reply to: DoctorJoe@aol.com: "Re: Mitral Valve Prolapse" Next in thread: Garry E. Siegel, M.D.: "Re: Mitral Valve Prolapse" Reply: Garry E. Siegel, M.D.: "Re: Mitral Valve Prolapse"

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