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Medically Compromised Patient Care

Course Number: 628

Cardiac Conditions No Longer Needing Antibiotic Prophylaxis

According to the AHA, there are conditions for which antibiotic premedication is no longer recommended due to the higher risk of antibiotic resistance and adverse events. The AHA states that patients with mitral valve prolapse (MVP) with or without regurgitation (i.e., murmur), rheumatic heart disease, bicuspid valve disease, calcified aortic stenosis and congenital heart conditions, such as ventricular or atrial septal defects and hypertrophic cardiomyopathy do not require antibiotic premedication (Table 4). Some dental patients may benefit from education on the current guidelines if they have been accustomed to taking premedication for these conditions in the past.

Table 4. Conditions No Longer Recommended for Premedication (AHA)
  • Mitral valve prolapse (MVP) with or without regurgitation (i.e., murmur)
  • Rheumatic heart disease
  • Bicuspid valve disease
  • Calcified aortic stenosis
  • Congenital heart conditions (CHD), such as:
    • Ventricular or atrial septal defects
    • Hypertrophic cardiomyopathy