I am a 32-year old female. I was diagnosed by echocardiogram with moderate mitral valve prolapse as a teen. At the time I was told to always take antibiotics before dental work or other invasive procedure, to prevent endocarditis. The doctor also mentioned the danger of strep throat turning into rheumatic fever and further damaging my mitral valve & warned me not to ignore possible strep outbreaks.
In the last five or so years I have have at least 10 bouts with strep in my right tonsil, which come on in a matter of hours accompanied by intense ear, throat and lymph node pain, but only on that side, and no other symptoms. I always go to the doctor right away, and am always put on penicillin, which always works. I have been advised by an ENT doctor that taking out this tonsil may stop this from happening so often. The tonsil is permanently distended with about a 3/4" diameter all the time.
My questions are:
1) Does my mitral valve prolapse actually put me at a higher risk of getting rheumatic fever, or is it just that since my mitral valve is already imperfect, I need to be sure nothing else happens to it?
2) At my age, do I even need to worry about rheumatic fever anymore?
3) Are doctors still recommending antibiotics before dental work? If so, what is the latest thinking on dosage and duration...I've heard that some people now just take one huge dose on the day of the procedure.
4) If I cut myself, does that also pose a risk of endocarditis?