Mitral Valve

About 12 years ago I was diagnosed with Mitral Valve Prolapse, and given an Rx for antibiotics for dental/surgical work. I recently had another echocardiogram, at my doctor's request, and they found no Mitral Valve Prolapse, but a small leakage in the Tricuspid Valve.  My doctor now says I don't need to take antibiotics.  I had to when I had Mitral Valve leakage, why don't I with Tricuspid Valve leakage?

[CCF-M.D.-MJM]

Hi Georgina,

We know from experience that people with significant mitral valve disease can develop a bacterial infection called endocarditis.  The bacteria in your mouth enter your blood stream during procedures like dental cleanings and root canals.  It can stick to the rough surface of the diseased valve and lead to very dangerous infection.

Ironically, the same is not true for the tricuspid valve.  It is very rare.  In fact, the risk of giving the antibiotics (which is very low) is greater than the risk of developing tricuspid valve endocarditis.  I can only speculate as to why that is case.  I looked for a reason online and in a few textbooks and didn't see it addressed.  Pressure in the left heart (where the mitral valve is) are about 3-5 times higher than pressure in the right side of the heart (where the tricuspid valve is).  That increased pressure and turbulence my make the surface the mitral valve more coarse and roughed up, making a better nesting site for blood bacteria.  This is only speculation.

You should not worry about developing endocarditis on your tricuspid valve.

I hope this helps.

[Sondra Elmore]

Awesome question, I was hoping to post a similar one.  I had PDA surgery at birth, now 33 and have a trace tricuspid leak.  My doctor never told me to take antibiotics before dental work.  Today I brought it up and he said absolutely, I must take penicillin before dental work?  Strange..I understand the trace, tricupsid is not something a cardiologiest would even entertain repairing?  I guess I've been fine so far, I've had plenty of dental work in the past.

[CCF-M.D.-MJM]

Article discusses indications for antibiotic prophalaxis.

http://www.clevelandclinicmeded.com/diseasemanagement/infectiousdisease/prophylaxis/prophylaxis.htm

[Don'tPostSoMuch]

Thank you.

[twj]

A related discussion, why was started.

[Lilgrace]

A related discussion, Prolaspe heart valve was started.