Pediatric Heart Expert Forum
How high is the risk of Endocarditis when getting a tattoo?
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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How high is the risk of Endocarditis when getting a tattoo?

To whom it may concern,
             Hi my name is Sam and I was born with Tetralogy of Fallot, which was corrected in 1987 at about a year old at Children's Hospital of Philadelphia by Dr. Norwood. On Oct 13, 2009 i had a very successful pulmonary valve replacement at CHOP by Dr. Thomas Spray. I have had absolutely no post-operation problems and I am in the best shape of my life, but I have a few questions on the topic of Tattoos and endocarditis. I've been interested in tattoos for a long time now but have been quite weary of acquiring one because of the risk of endocarditis.My Questions are:

1) If I take an antibiotic before i get the tattoo and through the the healing stage how much does this help prevent endocarditis?
2) Is it comparable to the risk I'm taking when I go to the dentist and have to take my antibiotics?
3) Is the risk comparable to anything else? (for example in rock climbing or skydiving there are many variables that could cause you injury or even mortality but because i am educated on the subject I can justify taking the educated risk)

     My Cardiologist, though i expected this, said that the antibiotics may confer protection but one can never be too careful or certain that a mishap (endocarditis) may occur. In hindsight I take chances and risks almost everyday when I rock climb, skydive, or surf. I cannot justify getting a tattoo if the chances of having problems with endocarditis are quite evident and substantial, though in my research i have read (not sure if it's fact) that the risk of endocarditis is not nearly as high as initially thought to be. What i am trying to say isf that I am fully aware of what endocarditis is and that there is a risk and possibility of endocarditis occurring because of dirty tattoo equipment and having an open wound susceptible to infection. What I don't completely comprehend is how probable or even plausible it is for one to get endocarditis through tattooing when taking the appropriate precautions.
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I do not think that we know any numbers of what the risk for endocarditis is under the circumstances of getting a tattoo.  Endocarditis is, fortunately, an uncommon complication of congenital heart disease, but when it occurs, it is devastating.  Therefore, most pediatric cardiologists feel that any risk is too much.  Of course, we find ourselves in situations where a penetrating skin injury occurs, that could result in bacteria in the blood stream, and fortunately most of the time nothing bad happens.  But many times these are unexpected situations.  Piercings in "dirty" areas (lips, nose, eyebrows, etc) and tattoos are planned risks.  Why take them? It sounds like your life is otherwise very full and a testimonial to how well patients with complex congenital heart disease can do!
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Jeffrey R Boris, M.D.Blank
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