Question

A 25-year-old patient is undergoing tooth extraction for dental caries. Which of the following does not require prophylaxis against infective endocarditis? 

• A. Prior history of endocarditis
• B. Atrial septal defect
• C. Unrepaired cyanotic heart disease
• D. Prosthetic heart valves

Answer 1

The Correct Option is B

In the context of tooth extraction and the risk of infective endocarditis, certain conditions require prophylaxis due to an elevated risk of bacterial infection reaching the heart. The conditions mentioned in the question are:

• Prior history of endocarditis
• Atrial septal defect
• Unrepaired cyanotic heart disease
• Prosthetic heart valves

According to the guidelines, prophylaxis for infective endocarditis is recommended for patients with the following conditions:

• Previous history of infective endocarditis: Patients with a prior history are at increased risk for recurrence.
• Prosthetic heart valves: These can serve as surfaces for bacterial colonization.
• Unrepaired cyanotic congenital heart disease: These patients have an inherent risk due to abnormal blood flow patterns and possible shunts.

Atrial septal defect (ASD) does not generally require prophylactic treatment for procedures like tooth extraction. ASD is a common congenital heart defect characterized by an opening between the atria of the heart, but it usually presents a lower risk for infective endocarditis compared to other defects that create more direct blood flow abnormalities or include prosthetic components.

Therefore, based on the provided options, Atrial septal defect is the condition that does not require prophylaxis for infective endocarditis in this scenario.