Biomaterial Database

Mitral valve prolapse and bacterial endocarditis: when is antibiotic prophylaxis necessary? 1985

A J Hickey, and S W MacMahon, and D E Wilcken

We investigated the association between mitral valve prolapse (MVP) and bacterial endocarditis (BE) in a case-control study of 56 patients with BE and 168 age- and sex-matched controls who had had echocardiography. Cases and controls were selected from patients without other known cardiovascular risk factors for BE. Twenty percent of the BE cases (11 of 56) and 4% of the controls (7 of 168) had MVP; the odds ratio of 5.3 (95% confidence interval 2.0 to 14.4) indicated a significantly greater risk of BE in patients with MVP. This increased those who had preexisting systolic murmurs (9 of 11). Exposure to repeated vascular instrumentation also increased the risk of BE (odds ratio 6.2, 95% confidence interval 2.3 to 16.4); this was independent of the risk associated with MVP. Based upon these data and the incidence of BE in New South Wales, Australia, in 1980, we estimate that 14 of every 100,000 adult patients with MVP would develop BE over a 1-year period, compared with three people in every 100,000 without other known risk factors for BE in the general population. Thus, although the risk of BE is five times greater in patients with MVP, the absolute risk remains small. This indicates that antibiotic prophylaxis is unnecessary for the majority of patients with MVP. We suggest that for patients with MVP not otherwise known to be at high risk of BE, routine antibiotic prophylaxis should be advised only for those who have systolic murmurs.

UI	MeSH Term	Description	Entries
D007263	Infusions, Parenteral	The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.	Intra-Abdominal Infusions,Intraperitoneal Infusions,Parenteral Infusions,Peritoneal Infusions,Infusion, Intra-Abdominal,Infusion, Intraperitoneal,Infusion, Parenteral,Infusion, Peritoneal,Infusions, Intra-Abdominal,Infusions, Intraperitoneal,Infusions, Peritoneal,Intra Abdominal Infusions,Intra-Abdominal Infusion,Intraperitoneal Infusion,Parenteral Infusion,Peritoneal Infusion
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D008945	Mitral Valve Prolapse	Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.	Floppy Mitral Valve,Mitral Click-Murmur Syndrome,Systolic Click-Murmur Syndrome,Click-Murmur Syndrome,Mitral Valve Prolapse Syndrome,Prolapsed Mitral Valve,Click Murmur Syndrome,Click-Murmur Syndrome, Mitral,Click-Murmur Syndrome, Systolic,Click-Murmur Syndromes,Floppy Mitral Valves,Mitral Click Murmur Syndrome,Mitral Valve Prolapses,Mitral Valve, Floppy,Mitral Valve, Prolapsed,Mitral Valves, Floppy,Mitral Valves, Prolapsed,Prolapse, Mitral Valve,Prolapsed Mitral Valves,Prolapses, Mitral Valve,Syndrome, Click-Murmur,Syndrome, Mitral Click-Murmur,Syndrome, Systolic Click-Murmur,Syndromes, Click-Murmur,Systolic Click Murmur Syndrome,Valve Prolapse, Mitral,Valve Prolapses, Mitral,Valve, Prolapsed Mitral,Valves, Prolapsed Mitral
D004697	Endocarditis, Bacterial	Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use.	Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial
D005260	Female		Females
D006337	Heart Murmurs	Heart sounds caused by vibrations resulting from the flow of blood through the heart. Heart murmurs can be examined by HEART AUSCULTATION, and analyzed by their intensity (6 grades), duration, timing (systolic, diastolic, or continuous), location, transmission, and quality (musical, vibratory, blowing, etc).	Cardiac Murmurs,Diastolic Murmurs,Innocent Murmurs,Cardiac Murmur,Diastolic Murmur,Heart Murmur,Innocent Murmur,Murmur, Cardiac,Murmur, Diastolic,Murmur, Heart,Murmur, Innocent,Murmurs, Cardiac,Murmurs, Diastolic,Murmurs, Heart,Murmurs, Innocent
D006435	Renal Dialysis	Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.	Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths