PROTOCOLS FOR PRE-MEDICATION

Cardiac Conditions Associated With Bacterial Endocarditis Reported By The American Heart Association

1. High-Risk Category-endocarditis prophylaxis recommended

• Prosthetic cardiac valves, including bioprosthetic and homograft valves
• Previous bacterial endocarditis complex cyanotic congenital heart disease (e.g., single ventricle states, transposition of the great arteries, tetralogy of Fallot)
• Surgically constructed systemic pulmonary shunts or conduits

• Most other congenital cardiac malformations (other than above or below)
• Acquired valvular dysfunction (e.g., rheumatic heart disease)
• Hypertrophic cardiomyopathy
• Mitral valve prolapse with valvar regurgitation and/or thickened leaflets

3. Negligible-Risk Category-no greater risk than the general population-endocarditis prophylaxis not recommended

• Isolated secundum atrial septal defect
• Surgical repair of atrial septal defect, ventricular septal defect or patent ductus arteriosus (without residua beyond six months)
• Previous coronary artery bypass graft surgery
• Mitral valve prolapse without valvar regurgitation
• Physiological functional or innocent heart murmurs
• Previous Kawasaki disease without valvar dysfunction
• Previous rheumatic fever without valvar dysfunction
• Cardiac pacemakers (intravascular and epicardial) and implanted defibrillators