Non-Specific ST-T Changes and Antibiotic Prophylaxis for Mitral Valve Issues

Issues with Electrocardiogram Reports and Medication Concerns

Hello Doctor, I have two questions I would like to ask.

1.
I recently had a health check-up and just received my report, which indicates non-specific ST-T changes.
Since I have not had this issue in previous examinations, I would like to know what could cause this condition.
I have a history of mitral valve prolapse and mild mitral and tricuspid regurgitation, as well as first-degree atrioventricular block.
Could these issues be contributing to the ST-T changes?
2.
Additionally, I have seen literature suggesting that individuals with mitral valve prolapse and regurgitation may need to take antibiotics to prevent endocarditis during dental and surgical procedures.
However, I am unsure if this applies to mild cases.
I reviewed some literature but still find it unclear whether I need to inform my dentist about the need for antibiotics when undergoing treatments such as cavity fillings, dental cleanings, tooth extractions, or root canal therapy.

I apologize for the complexity of my questions, and I appreciate your willingness to take the time to respond.
Thank you.

cindy, 20~29 year old female. Ask Date: 2020/11/10

Dr. Wu Xueming reply Cardiology

1.
If the patient has no risk factors for cardiovascular disease and no typical symptoms of cardiovascular disease, non-specific ST-T changes on the electrocardiogram have no clinical significance.
2.
Mild mitral valve prolapse does not require antibiotic prophylaxis to prevent endocarditis.

Reply Date: 2020/11/10

More Info

Hello! Thank you for your questions regarding non-specific ST-T changes and antibiotic prophylaxis for mitral valve issues. Let's address each of your concerns in detail.

1. Understanding Non-Specific ST-T Changes
Non-specific ST-T changes on an electrocardiogram (ECG) refer to alterations in the ST segment and T wave that do not point to a specific cardiac condition. These changes can arise from various factors, including:
- Electrolyte Imbalances: Abnormal levels of potassium, calcium, or magnesium can affect the heart's electrical activity.

- Medications: Certain drugs, including diuretics and antiarrhythmics, can lead to ST-T changes.

- Myocardial Ischemia: Even mild ischemia can cause non-specific changes, especially if there are underlying coronary artery issues.

- Structural Heart Conditions: Given your history of mitral valve prolapse and mild regurgitation, these structural abnormalities can indeed contribute to non-specific ST-T changes. The heart's electrical conduction system may be affected by the mechanical changes in the heart's structure, leading to variations in the ECG.

- Autonomic Nervous System Influence: Stress, anxiety, or other autonomic influences can also cause transient ST-T changes.

In your case, the presence of mitral valve prolapse, mild regurgitation, and first-degree atrioventricular block could potentially contribute to these non-specific changes. While they are often benign, it is essential to correlate these findings with any symptoms you may be experiencing and to discuss them with your healthcare provider for a comprehensive evaluation.

2. Antibiotic Prophylaxis for Mitral Valve Issues
Regarding antibiotic prophylaxis for dental procedures or surgeries, the guidelines have evolved over the years. Historically, patients with mitral valve prolapse (MVP) or regurgitation were advised to take antibiotics before certain dental and surgical procedures to prevent infective endocarditis. However, current recommendations from organizations such as the American Heart Association (AHA) have become more conservative.

- Current Guidelines: Antibiotic prophylaxis is generally recommended for patients with a history of infective endocarditis, prosthetic heart valves, or specific congenital heart defects. For patients with mild mitral valve prolapse or mild regurgitation without a history of endocarditis, prophylaxis is usually not necessary for routine dental procedures, including cleanings, fillings, or extractions.

- Specific Procedures: For more invasive procedures, such as root canal therapy or surgical interventions, it is advisable to consult both your cardiologist and dentist. They can assess your specific risk factors and determine whether prophylaxis is warranted based on your overall health and the nature of the procedure.

Conclusion
In summary, non-specific ST-T changes can arise from various factors, including structural heart issues like mitral valve prolapse. It is crucial to have a thorough discussion with your healthcare provider to understand the implications of these findings in your specific context. Regarding antibiotic prophylaxis, mild mitral valve issues typically do not require antibiotics for routine dental work, but it is always best to consult with your healthcare team for personalized advice.

Thank you for your thoughtful questions, and I hope this information helps clarify your concerns! If you have any further questions, feel free to ask.

Similar Q&A

Managing Mitral Valve Prolapse: Treatment Options and Medication Guidance

In 2003, I visited the emergency department due to suspected panic attacks, and the electrocardiogram (ECG) showed no abnormalities. In 2006, a health check revealed ST segment or T wave changes, and I was diagnosed with "myocardial infarction" at a regional hospital. A...

Dr. He Dongjin reply Cardiology
Dear Tony, I also believe that there is no need for aggressive treatment of mitral valve prolapse; instead, focusing on mental health treatment is sufficient. Taking Inderal can help avoid tachycardia. I am skeptical about the claim that it protects the heart, and considering the...

Managing Mild Mitral Valve Prolapse: The Importance of Periodontal Treatment

Hello Doctor: I have mild mitral valve prolapse, which was discovered during an echocardiogram in middle school. Since then, I have undergone about five echocardiograms over the past five years, all showing mild mitral valve prolapse. A few months ago, I consulted with my family ...

Dr. Ding Zhizhong reply Cardiology
Hi Peter: Essentially, mitral valve prolapse is a quite common condition, and many people attribute unexplained palpitations or chest pain to it. However, so far, surgical treatment is only considered if there are significant symptoms (such as severe regurgitation affecting heart...

Understanding Rytmonorm: Effects on Mitral Valve Issues and Heart Health

I have a problem with my mitral valve. I have been taking Rytmonorm for six months. Recently, my electrocardiograms have been normal, but I'm not sure if it's due to the medication. Another hospital mentioned that taking this medication might be too serious for me.

Dr. He Dongjin reply Cardiology
I am unclear why the mitral valve requires this medication. I believe the prescribing physician has their considerations. You may want to consult your original outpatient physician or seek further evaluation at another cardiology clinic. The information you provided is too limite...

Mitral Valve Prolapse: Dietary, Exercise, and Medication Guidelines

Hello, I had a cardiac ultrasound this month, and the results are as follows: 1. Normal chamber size and wall thickness. 2. No regional wall motion abnormalities. 3. Normal left ventricular function. 4. Mitral valve prolapse with mild mitral regurgitation. 5. Mild tricuspid regur...

Dr. Wu Xueming reply Cardiology
1. No 2. Not likely 3. The presence of mitral valve does not increase the risk of thrombosis, but oral contraceptives themselves carry a risk of thrombosis. Please discuss the benefits and risks of using this medication with your obstetrician-gynecologist.