According to American Heart Association infective endocarditis guidelines, which scenario is considered high risk for IE prophylaxis?

• A. Prosthetic heart valves
• B. Asthma
• C. Diabetes
• D. Hypertension

Answer: (A)

Prophylaxis for infective endocarditis is kept for those with conditions that put them at the highest risk for serious infection if bacteremia occurs. A prosthetic heart valve creates a surface where bacteria can more easily adhere and form endocarditis, and infections on prosthetic valves are particularly difficult to treat and can be life-threatening. Because of that elevated risk, antibiotic prophylaxis is recommended for procedures that may cause bacteremia in these patients.

Asthma, diabetes, and hypertension do not by themselves place a patient in the high-risk category defined by current guidelines, so prophylaxis is not routinely indicated for these conditions.