 |  cardio Q
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| Author | 7 Posts |
nadiabarati
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A slim, healthy 30 year old woman is scheduled for a dental prosthodontic procedure and was sent for medical evaluation of a known history of mitral valve prolapse (MVP). The patient is a highly active individual and denies palpitation, chest pain, or shortness of breath. She admits to having a family history of heart disease, notably her father, who had died of a heart attack in his forties, and her mother, who had mitral valve prolapse. On physical exam, the patient is comfortable and has normal vital signs. Auscultation of the heart reveals a normal S1 and S2 and a prominent midsystolic click, which is accentuated in the standing position. No systolic murmur is appreciated. What is your overall assessment and plan for this patient? A. Gen an echocardiogram to evaluate mitral valve motion and blood flow prior to clearing her for the procedure.
B. Prescribe empiric antibiotics for endocarditis prophylaxis and clear her for the procedure.
C. Get a cardiology consultation prior to medical clearance because the patient has a significant family history of heart disease.
D. Clear her for the procdure without endocarditis prophylaxis.
E. Clear her for the procedure with endocarditis prophylaxis.
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| saadtazjam
Forum Elite
Topics: 9
Posts: 160
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D???
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,509
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www.infoplex.northwestern.edu/academic/clinical/medicine9.doc
i think just stick to this one..
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,509
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Mitral valve prolapse without valvar regurgitation1--no endocarditis prophylaxis. now in the above pt we have no murmur. but can we say for sure whether there is regurg or not, do we need the echo?
im stuck btw a and d. in general Physical signs are nto a 100% reliable, so id lean more towards A
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If you yourself are at peace, then there is at least some peace in the world.
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| ndspider
Forum Senior
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Man, study_ing that is a great article!
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| AAzad
Forum Guru
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2 gr. of Amoxi does not hurt.
patient is too young for routin echo,and even if you find changes on mitral, you already covered with amoxi.
what do you think?
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AAzad
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| Geroo
Forum Guru
Topics: 114
Posts: 799
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I go with D
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