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British Heart Foundation
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Body piercing and tattoos - congenital heart disease (bicuspid valve)

hi all, first time poster. I have 4 tattoos and one body piercing, did all this pre-discovering I have a bicuspid valve (diagnosed 3 days ago, age 34 currently no issues and to be monitored annually as i am at the upper threshold of “normal” aortic thickness). What I’m wondering is would my piercing still pose a high risk of infection for my situation? I hope not...

secondly, I was planning on getting another tattoo - is this a bad idea? It is a well known place that has an excellent hygiene record, I’m just not sure about how serious the risks are if I do get infected. Can you get endocarditis from say, a very bad cut that gets infected? I’ve been trying to understand the link between endocarditis and infection, I get the oral infection link. Any insight would be greatly appreciated! And is the risk higher once you’ve had a repair/replacement? Sounds like you’re at highest risk post-surgery, is pre-surgery much lower than?

thanks again

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There is no easy answer to this. Endocarditis is caused by bacteria with many causes such as gum disease, poor catheter care and unsterile needles. A few years ago your GP would have probably given you antibiotics as a precaution but under new guidelines getting a prescription is a nightmare. My own bypass was delayed by over a month because of constant refusals to prescribe antibiotics for an abscessed tooth. I was given them two weeks after the extraction! The risk you would take is small. In your position I would see if your GP would prescribe antibiotics. If not I would leave it. This is a personal view!

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Thanks for your reply. Thats insane that you had such issues to get it for an abscessed tooth. When i brought up dental cleaning and whether i should take antibiotics to my cardiologist he said to err on the side of caution so i’ll take your advice and ask him re tattoos (and dental work!)

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Hi Lvp84

Sorry to hear this is all new to you, it can be hard to process. Unfortunately, you can get endocarditis from various routes, the mouth being one but yes any damage or cut to the body potentially can introduce an infection into the bloodstream.

Endocarditis is inflammation of the inner lining of your heart caused by infection from bacteria, and it can damage your own heart valve, but once you have a replacement it can be extremely difficult to clear the infection from a prosthetic valve as it isn't your own body tissue. For some endocarditis patients who haven't had a valve replacement yet, their heart function deteriorates during their antibiotic treatment and they need emergency valve surgery.

If your diagnosis is new, it may be better to delay a decision about a new tattoo until you've had time to talk to other people who have had prosthetic valves or who have valve issues so understand the heightened risk? Ultimately it will always be your decision, but hopefully others in your position will respond to this post and help you weigh up your decision. If you would like to speak to a cardiac nurse about endocarditis, please call us on 0300 330 3311.

Best of luck,

Ashleigh

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Hi Ashleigh, thank you so much for your detailed response thats really helpful. I’ll see if others with the same issue and can shed some further light will comment. Many thanks again

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Ah, that finally makes sense to me as to why we are more at risk - flow of blood and roughness etc. Thanks for that explanation! I see what you mean re bacteria and tattoos / piercing the skin. I guess taking an antibiotic before the procedure helps but the challenge would be getting that prescription. This may seem like a silly question, but it is a certain type(s) of bacteria that causes the endocarditis right? And these are rare? So if there was an infection, its not necessary the really bad type? Or have I misunderstood and its basically any infection can travel in the bloodstream and cause issues? Just thinking about piercing and how its still an open wound, if that got infected now, that could travel through my bloodstream (or is this really really rare?). Apologies i probably totally missing something here and I want to be sure on what my risks on, lots of information online but not clear on other infections / bacteria.

Thanks again for sharing your experience and knowledge, its all helpful. Ill have to think about this one but the risk does seem small (but potentially disastrous, i know!)

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I’ve been told to not t have a back or chest tattoo. My cardiologist spoke to me about it as a teen but I’ve had my ears pierced and didn’t get encocarditis from my ears. I’ve had it from dental issues onli. My freind has the same heart condition and has tats and he hasn’t had endocarditis, but get the place checked before u get any piercings or tats.

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Hi,

I recently got diagnosed with same condition and I was also advised against tattoos and piercings. However, same as yourself I already have tattoos and piercings! It's a big part of my creative personality. I asked my cardiologist about it and he said it is personal choice, however there is just a more increased risk with the mentioned infection. He just recommended a place with excellent hygiene. Of course, this goes without saying. I still would like more tattoos! Good luck on your journey, whatever you decide 😊

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Hi Lvp84, I hope you’re feeling ok after your diagnosis.

I’m so sorry to be negative, but personally, I wouldn’t risk it.

I’ve just had endocarditis and it was the most horrible experience of my life. I’ve been in hospital for 7 weeks. I was suffering unbearable symptoms and was on the verge of death when admitted. I spent 3 weeks on IV antibiotics every 4 hours. I felt like I was losing my sanity, couldn’t understand half of what was going on.

I found out through a scan that I was born with a bicuspid aortic valve, i’m 44 and had no idea until now.

I know the bicuspid valve made me susceptible to the endocarditis, but I have no idea what the other risk factor or trigger was. Risk factors can include cuts, gum disease, dental treatment, piercings, tattoos, IV drug use, illnesses that cause internal bleeding, but there is often (as in my case) no obvious cause other than a susceptibility such as the bicuspid valve.

I’m now recovering from open heart surgery (they can’t do the less invasive op on endo patients). The aortic valve was damaged by the endocarditis and i’ve got a artificial one, which should last my whole life. I’ll also be on warfarin for life, which needs careful monitoring especially at first.

I’m now in an even higher risk group for endocarditis, as it’s more likely for people who have already had it, plus for people with replacement valves.

So personally I definitely won’t be having a tattoo, which I was considering before this. I know everyone’s different, it’s your choice at the end of the day, but I wouldn’t want to risk it myself, as you’re in a vulnerable group for endo now due to bicuspid valve and then will still be vulnerable after the valve is replaced.

Unless the piercing is recent, I can’t see it being a risk, but others might know more about that.

Good luck X

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Hi Amikatari,

Thank you so much for your response, and of my gosh i’m so terribly sorry about what has happened - what a terrifying experience, literally my worst nightmare catching endo. I’m so glad you survived it and will be able to live a full life.

I actually went ahead and carried out the tattoo, my reasoning was that after reading a lot online i understood that whilst i’m definitely at risk, you are much more at risk if you have already had a valve replacement. I figured gum disease/ dental hygiene has got to be the most risky with the amount of germs in our mouth. Probably was a silly decision, i also meant to take antibiotics but forgot to on the day! I finish my tattoo (it’s a big piece) in June and plan to take the antibiotics as a precaution before the session...

Fingers crossed. I won’t be getting anymore after this one is complete...

Best of luck with your recovery

Lara

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