The reliability of the medical history in the identification of patients at risk for infective endocarditis

Article Abstract:

Infective endocarditis (IE), inflammation of the membrane surrounding the heart, is a complication which may develop after invasive dental procedures. Patients who are at risk for developing IE typically have congenital heart disease or underlying vascular disease. However, sometimes these patients have no symptoms and have therefore not been identified as being at risk. The use of antibiotics to help prevent IE may be wise when high-risk individuals undergo invasive dental procedures. Dentists usually ascertain the risk factors by medical information provided to them by the patient, which may be unreliable. Recent studies also indicate that some dentists do not feel the need for inquiries into the patient's medical histories. In an effort to assess the reliability of patients' self-reported medical histories and the usefulness of questionnaires, a survey was performed using 30 asymptomatic patients. All subjects believed they had a history of heart disease when questioned about their medical histories. In addition, the subjects were examined by a cardiologist and they underwent echocardiography. Out of the total group of 30 patients, 14 (47 percent) had probable or definite valvular heart disease. All 14 were advised to take antibiotics prior to invasive dental work; only two of this group had been previously advised of this recommendation for antibiotic treatment. The results of these data also indicated that, in general, the oral medical histories reported by the patients were unreliable. This, combined with inaccuracies in the questionnaires, led to a number of false-negative responses and some patients who were at risk were not properly identified. Overall, these results confirm the unreliability of these methods in assessing cardiac conditions in dental patients. Because of the potentially fatal consequences of IE, all questionable patients should be routinely referred for a complete cardiac evaluation with echocardiography prior to invasive dental treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Prevention, Health risk assessment, Echocardiography, Cardiac patients, Endocarditis

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The evidence base for the efficacy of antibiotic prophylaxis in dental practice

Article Abstract:

The analysis of panel data to determine the benefits of receiving antibiotic prophylaxis before undergoing dental procedures is presented.

Analysis, Antibiotics, Dental care, Protection and preservation, Mouth, Oral hygiene, Medical protocols, Dental hygiene, Antibiotic prophylaxis

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Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents

Article Abstract:

The effects of dual antiplatelet therapy cessation after coronary stenting on myocardial infraction associated mortality are presented.

Complications and side effects, Prognosis, Drug therapy, Heart diseases, Heart attack, Dosage and administration, Blood platelets, Stent (Surgery), Stents, Platelet aggregation inhibitors

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