Mitral Valve Prolapse

[mia]

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?

[Cleveland Clinic, MD]

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?
A: This is controversial but the current recommendation is that unless there is regurgitation associated with the prolapse there is no need for antibiotics.

     2) At my age, do I even need to worry about rheumatic fever anymore?
A: Yes.

     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.
A: For individuals at risk the dosage is 2 gms amoxicillin one hour prior to the procedure.

     4) If I cut myself, does that also pose a risk of
endocarditis?
A: No.

[Donna]

Great questions on mvp.  I too have mvp with reguitation.  I wonder why the dentist and doctors went from giving you antiobotics three days prior to dental work and then you took them I think four days afterwards to taking a very very large amount of antibotics at one time six hours before dental work and another large amount again at one time so many hours later.  Is there not a risk of taking so many antibotics at one time?  
I was told by my doctor to not let any infections go and as far as sore throats go I was told if I ran a fever over 100.4 with a sore throat to come in and see the doctor.  
Good question on the getting cut and if it can cause infection.

Good Luck!

[Cleveland Clinic, MD]

Thanks for your comments.