Which patient requires antibiotic prophylaxis before a dental extraction according to current ACC/AHA recommendations?
- A A 40-year-old with repaired ventricular septal defect using a prosthetic patch placed 5 years ago
- B A 55-year-old with a bileaflet mechanical aortic valve ✓
- C A 30-year-old with a history of uncomplicated Kawasaki disease without residual coronary or valvular involvement
- D A 65-year-old with moderate calcific aortic stenosis
Correct answer: B. A 55-year-old with a bileaflet mechanical aortic valve
Explanation
Prophylaxis is limited to patients with prosthetic valves, previous infective endocarditis, unrepaired cyanotic congenital heart disease, repaired defects with prosthetic material only during the first 6 months, or valvular regurgitation in transplanted hearts. A patch older than 6 months, resolved Kawasaki disease, and native moderate stenosis do not qualify. Standard adult regimen is oral amoxicillin 2 g one hour before the procedure.
Reference: Braunwald's Heart Disease, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.