Which of the following cardiac conditions requires prophylactic antibiotics before procedures: hypertrophic cardiomyopathy, bicuspid aortic valve, aortic stenosis, mitral valve prolapse with mitral regurgitation, or prosthetic aortic valve?

Infective endocarditis antibiotic prophylaxis indications for cardiac conditions

Prophylactic antibiotics before procedures are recommended only for patients with the highest risk cardiac conditions that predispose to serious outcomes from infective endocarditis. [1] Among the listed conditions, only a prosthetic aortic valve meets this high-risk criterion. [1]

Conditions that do require prophylaxis

• Prosthetic (artificial) heart valve (including a prosthetic aortic valve) [1]
• Prosthetic material used for valve repair [1]

Conditions that do not require prophylaxis among the listed options

• Hypertrophic cardiomyopathy [1]
• Bicuspid aortic valve [1]
• Aortic stenosis (native valve disease) [1]
• Mitral valve prolapse with mitral regurgitation (native valve disease) [1]

Procedure context for prophylaxis

Prophylaxis applies to specific dental procedures that involve manipulation of gingival tissue, manipulation of the periapical region of teeth, or perforation of the oral mucosa in patients at highest risk. [1]

Related clarification on non-dental procedures

For patients at high risk of infective endocarditis, prophylaxis is not recommended for most nondental procedures in the absence of active infection. [2]