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There are many ways you can help children and their families get the care they need.
Ordinarily, the heart has a smooth lining, making it difficult for bacteria to stick to it. But people with congenital heart disease may have a rough area on the lining, which could be caused by conditions including:
These rough areas inside the heart are opportune places for bacteria to build up and multiply.
Bacteria can enter the body in many ways. According to the American Heart Association (AHA), some of the most common ways include the following:
People with CHD may have an increased risk of developing an infection inside the heart. The greatest risk is in those with chronic cyanotic heart conditions and/or pulmonary hypertension/Eisenmenger's syndrome. Other conditions that put people at increased risk include those with:
While each child may experience symptoms differently, the usual sign of bacterial endocarditis is when your child with CHD has prolonged fever for two to three days after a procedure in the mouth, intestinal tract or urinary tract. However, keep in mind that the infection may occur without a procedure. Other symptoms may include:
An important step in preventing bacterial endocarditis is helping your child maintain excellent oral hygiene, including regular brushing and flossing. Regular visits to the dentist for professional cleaning and check-ups are essential.
Prophylaxis (preventative medicine) is another way to guard against bacterial endocarditis. In this case, your child might take one dose of an antibiotic before a procedure that could put him at risk. In most cases, the antibiotics can be given by mouth instead of through a shot or an intravenous (IV) line.
If your child has had a simple patch or heart valve repair, he may only need pre-procedure prophylaxis antibiotics for the first six months following the surgery, until natural tissue grows over the artificial material and makes it smooth.
In 2007, after an extensive review of the research, the American Heart Association's Endocarditis Committee and international experts developed new guidelines for the use of prophylaxis to prevent bacterial endocarditis.
Previously, everyone with CHD would receive antibiotics before dental and other invasive procedures to prevent endocarditis. The new guidelines, however, recommend antibiotics before dental procedures only for the cardiac conditions associated with the highest risk of complications from endocarditis. These are:
The new guidelines have also been endorsed by the Infectious Diseases Society of America, the Pediatric Infectious Disease Society and the American Dental Association.
If your child is a candidate for preventive antibiotics, one of our doctors, nurses or cardiologists might give you a prescription.
Please talk to your child's physician about any further questions you may have about risk factors or preventive measures.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”