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Type: Journal article
Title: Cardiac murmurs: echocardiography in the assessment of patients requiring antibiotic prophylaxis for dental treatment
Author: Ching, M.
Straznicky, I.
Goss, A.
Citation: Australian Dental Journal, 2005; 50(4SU Sup 2):S69-S73
Publisher: Australian Dental Assn Inc
Issue Date: 2005
ISSN: 0045-0421
Statement of
M. Ching, I. Straznicky and AN Goss
Abstract: Background: Traditionally patients who indicate that they have a heart murmur or who indicate that they have had rheumatic fever are given antibiotic prophylaxis for dental treatment. This is commonly done without further assessment of the patient’s actual endocarditis risk. Echocardiography is a noninvasive method of assessing cardiac valve function and haemodynamics. Methods: Consecutive patients who were referred to a private practice oral and maxillofacial surgeon for dentoalveolar surgery and indicated that they had a cardiac problem and usually had antibiotic prophylaxis, were evaluated. Those with a clear indication for prophylaxis, for example had prosthetic heart valves or previous infective endocarditis, received antibiotic prophylaxis. Where there was uncertainty, they were referred for an echocardiogram, and if abnormal, a formal cardiology review. Results: Three hundred and seventy patients out of approximately 20 000 (1.85 per cent) indicated that they had a cardiac murmur and usually received antibiotic prophylaxis for dental treatment between 1 February 1997 and 1 February 2005. Two hundred and sixty-two (71 per cent) were female and 108 (29 per cent) were male; age range 0.7 to 98 years, average 37.6 years. Two hundred and seventy (72 per cent) had normal hearts with no indication for antibiotic prophylaxis. Of the 100 (28 per cent) patients with abnormal findings, they were on average older; 49.5 years, range 0.7 to 87 years. Of these, 50 (14 per cent) met current indications for antibiotic prophylaxis. Conclusion: Patients who present for dental treatment indicating that they require antibiotic prophylaxis for cardiac condition need to be fully evaluated. In this study only 50 of 370 patients (14 per cent) required antibiotic prophylaxis. The remaining 320 (86 per cent) would have no benefit but a risk of adverse reaction to the antibiotic.
Keywords: Humans
Endocarditis, Bacterial
Rheumatic Fever
Heart Murmurs
Antibiotic Prophylaxis
Dental Care
Aged, 80 and over
Middle Aged
Child, Preschool
Description: The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.
DOI: 10.1111/j.1834-7819.2005.tb00389.x
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