Body art, tattooing all over, could be an alluring fad. But it carries significant risks for patients with congenital heart disease, UK doctors have warned. Even ear-piercing could prove problematic, they say.
In recent years, there have been several reports of people developing endocarditis and other serious infections after tattooing and body piercing, and infection has resulted in at least one death. Infective endocarditis occurs when bacteria or fungi attaches and begins to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.
Dr. Suhair O. Shebani from Glenfield Hospital, Leicester, and colleagues conducted a survey of 600 patients attending pediatric cardiology clinics and 69 pediatric cardiologists, some of whom were still treating adults with congenital heart disease.
Of the 486 heart patients surveyed, 87 (about 18 percent) had body art; 86 patients had piercings, and one had a tattoo. One of these individuals developed endocarditis after an ear piercing. The average age of the piercing group was 12 years, while the patient who got the tattoo was 15 years old.
Sixty-two percent of these young people (54 out of 78) were not aware that they should talk to their doctor before tattooing or piercing their body.
Among the 33 patients who sought advice about body art, 12 asked their heart doctor: 4 were advised against it, 6 were told to take sterile precautions, and 2 were told that there was no need for precautions.
Twenty-one patients sought advice from non-heart specialists: 5 were advised against body art, 8 were advised to take precautions, and 8 were told there was no need for precautions.
"While it is worrying that most patients in our group did not seek advice before having body art, it is of greater concern that those who did seek advice were given such widely varying recommendations," Shebani and colleagues write in Archives of Disease in Childhood.
They also find it troublesome that most of the pediatric heart doctors surveyed were not aware that tattooing could lead to an infection of the heart and most indicated that they did not routinely offer advice about body art.
"Body art in the form of tattoos and piercing has become increasingly popular amongst children and teenagers, and is nowadays more socially acceptable," the UK team notes in their report. "Better knowledge and education about the link between body art and endocarditis is required in order to provide guidelines for doctors and patients."
For the time being, Shebani and colleagues "strongly discourage all forms of body art." For those who cannot be dissuaded, they recommend antibiotics be given prior to tattooing or piercing, "with strong advice for prompt treatment of any signs of subsequent infection."
A recent study by the European Research Commission found that up to half of body piercings can lead to acute infection.