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Regular immunization programs should be followed in children with heart diseases. Particular attention must be given as to their hospitalization should not hamper the immunization program. In case of immune systems disorders in specific heart diseases, the vaccines cocuk-kalp05not recommended by your doctor should not be injected. Monitoring doctor would inform families of such vaccines. Since high temperature that occurs after vaccines can increase cardiac insufficiency in children with heart diseases, antifebriles need to be administrated to keep it under control.
 
Because the catarrh and influenza which are very common in winter can lead to more serious problems in children with heart diseases, flue vaccine must be injected in these children when they are older than six months. It is usually appropriate to use drugs like antibiotics and antifebriles. Your doctor will inform you about any inappropriate drugs.  
 
Games and Sports in Children with Heart Diseases
 
Games are essential part of childhood. Avoiding children from playing games produces adverse effects over their mental development and social life. If families know what type of games they should allow for children with heart diseases then they can avoid wrong actions like over-protectiveness. The type of heart disease and intensity of sporting activity play an important role in determining sports activities. Sporting activities can only be decided by the doctor who is monitoring the child. What kind of activities the child should perform must be determined by pediatric cardiologist, depending on the type of heart disease.
 
Classification of sports by their activity level:
 
•    Light sports: Marksmanship, bowling, archery,
•    Moderate sports: Golf, table tennis, walking
•    Heavy sports: Basketball, football, volleyball, cycling, swimming, tennis, wrestling.
 
Giidance for Protecting From Infective Endocarditis 
 
Heart diseases developed as result of rheumatism are likely to involve infective endocarditis. Infective endocarditis means that cardiac membrane or endothelium becomes inflamed by bacteria mixed in the blood. It is VITAL to follow the recommendations below to protect your child from this dangerous disease.
 
6.       Oral hygiene and dental care are highly important since most bacteria mixed in the blood are transmitted through mouth. Thus, the teeth must be brushed with a soft brush after the meals and after eating sweets, e.g. ice cream and candies, to prevent tooth decay.
7.         Decayed teeth are a major source of microbes. Decayed teeth should be filled or extracted if filling is not possible. Periodic checks by a dentist and treatment of newly decayed teeth are recommended.
8.        In any type of surgical interventions such as tooth extraction, root canal treatment and filling, removal of adenoid, tonsillectomy, hernioplasty, circumcision, and ear piercing, the risk of development of endocarditis is present. To protect from this disease, prophylactics should be used prior to any dental interventions and surgical interventions. For this, you should use indicated antibiotics under the supervision of your dentist or doctor.
9.      So, the following statement must be viewed by any dentists or doctors visited.
 
To Dentist or Physician it may concern,
 
This patient is at risk of infective endocarditis during any interventions leading to “bacteremia” due to cardiac rheumatism. Therefore, administration of medication prophylaxis which is indicated on the form must be administrated by our recommendations depending on the intervention to be applied.
 
Cases Requiring Prophylaxis
Group 1
•    Any dental interventions causing gingival bleeding,
•    Tonsillectomy and adenoidectomy, etc.
•    Opening abscesses, circumcision, ear piercing, tattoo, piercing.
Group 2
•    Any interventions involving digestive and urogenital system (endoscopy and biopsy)
 
Cases Not Requiring Prophylaxis
•    Spontaneous dentition of milk teeth
•    Falling, hitting, cut, scratch
 
Prophylaxis Diagram
In case of interventions in Group 1
 
Less than 30 kg:
•    Clindamycin, 1 hour before the intervention, 20 mg/kg (PO)
In case of no oral administration: Clindamycin ampoule, 30 min. before the intervention,  20 mg /kg (IV)
greater than 30 kg:
•    Clindamycin, 1 hour before the intervention, 600 mg (PO),
In case of no oral administration: Clindamycin ampoule, 30 min. before the intervention, 600 mg  (IV)
 
In case of interventions in Group 2
less then 30 kg:
Vancomycin 20 mg/kg, 30 min. before the intervention, all of it, infusion in an hour (IV)
greater than 30 kg:
Vancomycin 1 gr, 30 min. before the intervention, all of it, infusion in an hour (IV)