Pediatric Heart Expert Forum
Possible Endocarditis prevention
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Possible Endocarditis prevention

Hello, doc
  I am a 15 year old male that has Aortic Insufficiency and I have been wanting to get a tattoo.  My mom is training to be a nurse and has warned me about Endocarditis as my cardiologist has.  They both have said before that not getting a tattoo would be better becouse of the possible risk, however in my dental appointments I have taken an anti-biotic to help prevent Endocarditis. I was curious if I could take the same medication to help prevent Endocarditis while getting a tattoo. Thank you for reading my question.
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Dear Vacca,

Endocarditis is an infection of the lining of the heart that can occur in places where there is turbulent blood flow, such as at your aortic valve where there is turbulence from the leakage that is occurring.  Historically, endocarditis has been prevented by taking antibiotics prior to a procedure that is at high risk for introducing bacteria into the blood stream, such as certain kinds of dental, airway, intestinal, and urologic procedures.  In April 2007, the American Heart Association significantly scaled back their endocarditis prophylaxis recommendations, as it was felt that the risk was not nearly as high as initially thought for the majority of heart defects as well as for the majority of types of procedures.  Aortic valve insufficiency ceased to be a higher risk defect after the new guidelines, unless you have had endocarditis before.  Therefore, many cardiologists have stopped using endocarditis prophylaxis for dental procedures for aortic insufficiency, although there has also been a fair bit of individual variation with this based on the cardiologist’s knowledge of the patient’s specific situation.

Placement of a tattoo has not been felt to be a specific risk for endocarditis, either prior to or after the guideline changes.  That said, there are two things that need to be kept in mind when considering a tattoo.  One is to ensure that the facility that is performing the procedure uses the highest degree of hygiene, including sterile needles, cleaning off the skin with an antiseptic, etc.  The second is related to the first, which is that there are other infectious risks associated with tattooing that are not related to endocarditis, such as hepatitis B and C as well as HIV.
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