dental work,PPCM and hormones

  Hello,  I had PPCM. As of July 98 my ef=52% no valve problems.  My heart
  looks completely normal. My cardiologist said I don't have to worry about
  taking an antibiotic before any dental work.  Today I had a wisdom tooth
  filled. There was no antibiotic taken.  On the 22nd I am going to have a
  tooth extracted.  Should I error on the side of caution and get an antibio-
  tic or will it be ok not to take one?  While I am at it.  I have a hormone imbalance
  once the blood work comes back, my GP may put me on a birt control type pill
  with the proper hormones I need to even out.  Is this ok?  I am 29. I never
  experienced problems with th epill in the past. I don't have high blood
  pressure or anything like that.  I guess I have become confused about hormone
  pills and role they may play in heart diease.
     I really just want a educated 2nd opinion, notes froms your experience, so
  that I can better questions for my doctors and myself so that a decision
  can be better made.  
    Thank you ever so much for your time.
  Jamie

[CCF CARDIO MD APS]

Dear Jamie,
It does not appear that antibiotics are indicated in your case, i.e. from what
you say above.  There are clear cut guidelines as to who exactly needs antibiotic
prophylaxis, and there certainly is no evidence that there is any benefit of
taking antibiotic prophylaxis in those who do not have an indication.  There is
no "erroring on the side of caution" in medicince, rather it is evidence based
decision making that guides are care of patients.  
This is a cardiology forum, thus I can only comment as to the fact that currently
it is known that women in an post-menopause can benefit greatly from hormone replacement
therapy.  At 29 years or so of age you should follow the instructions on the label of the
birth control pills you are taking; more importantly, you should assess the risks and
benefits of all therapies that your physician suggests with him or her and then
make a decision yourself based on that information.  Just so you know, hormonal imbalances
of any patient should be addressed, treated, reassessed, etc.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.