Aortic stenosis prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]

Aortic Stenosis Microchapters

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Overview

Prevention of rheumatic fever is the best way to prevent development of this valvular heart disease. Any child who has a sore throat should see a doctor to treat any case of strep throat infections (by antibiotics) before progresses to rheumatic fever.

Prevention

Early antibiotic treatment of streptococcal infection prevents rheumatic fever and the development of aortic stenosis later on [1].

The incidence of rheumatic fever decreased before introduction of antibiotics, suggesting that other factors are involved [1].

Precautions

People with aortic stenosis of any aetiology are at risk for the development of infection of their stenosed valve, i.e. infective endocarditis. To lessen the chance of developing that serious complication, people with AS are usually advised to take antibiotic prophylaxis around the time of certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of esophageal varices, dilation of esophageal strictures, gastrointestinal surgery where the intestinal mucosa will be disrupted, prostate surgery, urethral stricture dilation, and cystoscopy. Note that routine upper and lower GI endoscopy (i.e. gastroscopy and colonoscopy), with or without biopsy, are not usually considered indications for antibiotic prophylaxis.

Not withstanding the foregoing, the American Heart Association has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to:

References

  1. 1.0 1.1 Dajani A, Taubert K, Ferrieri P, Peter G, Shulman S (1995). "Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association". Pediatrics. 96 (4 Pt 1): 758–64. PMID 7567345.
  2. http://www.americanheart.org/presenter.jhtml?identifier=4436


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