Infective Endocarditis

Updated:Oct 14,2014
Endocarditis illustration
View an illustration of endocarditis

Infective endocarditis (IE), also called bacterial endocarditis (BE), is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. IE is uncommon, but people with some heart conditions have a greater risk of developing it. 

Dental Procedures and Infective Endocarditis
In the past, patients with nearly every type of congenital heart defect needed to receive antibiotics one hour before dental procedures or operations on the mouth, throat, gastrointestinal genital, or urinary tract. However, in 2007 the American Heart Association simplified its recommendations. Today, antibiotics before dental procedures are only recommended for patients with the highest risk of IE, those who have:

  1. A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
  2. A history of endocarditis.
  3. A heart transplant with abnormal heart valve function
  4. Certain congenital heart defects including:
    • Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunts and conduits.
    • A congenital heart defect that's been completely repaired with prosthetic material or a device for the first six months after the repair procedure.
    • Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.

Key changes for patients with congenital heart defects
Preventive antibiotics are no longer recommended for any other congenital heart disease than these:

  • Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunts and conduits.
  • A congenital heart defect that's been completely repaired with prosthetic material or a device for the first six months after the repair procedure.
  • Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.

Additionally, taking antibiotics just to prevent endocarditis is not recommended for patients who have procedures involving the reproductive, urinary or gastrointestinal tracts.

If you still require antibiotic prophylaxis for dental treatment or oral surgery, your cardiologist may give you an American Heart Association wallet card (also available in Spanish). Show this card to your dentist, pediatrician, family doctor or other physician. It advises them to give you the proper antibiotic and dose. For smaller children, the dose will vary according to the child's weight. Always remind the dentist or doctor if you (or your child) are allergic to any antibiotics or other medications. Brushing, flossing, and visiting your dentist regularly helps keep your smile bright and prevents tooth and gum infections that could lead to endocarditis.

Your cardiologist can provide you more information and can answer your questions about preventing endocarditis.


Web Booklets on Congenital Heart Defects

blue papersThese online publications describe many defects and the procedures used to repair them. It’s organized so that you can print out the sections that relate to you or your child’s defect and concerns.
Ask the Pediatric Cardiologist

Find answers to common questions about children and heart disease. 


The Impact of Congenital Heart Defects

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