If you have a single patient in your practice who is potentially susceptible to bacterial endocarditis, you will be interested in the new recommendations of the American Heart Association published in this issue of AJDC.1 Bacterial endocarditis is an infrequent, but severe, complication of congenital heart disease. In certain circumstances it is preventable. The American Heart Association recommendations attempt to define these circumstances and the actions that you can take to prevent endocarditis.
Several changes from previous recommendations have been made by the Committee on Rheumatic Fever and Bacterial Endocarditis of the American Heart Association. Risk levels have been stratified, a two-dose antibiotic regimen has been suggested, and the relative risk of bacteremia in clinical circumstances has been clarified. In addition, dental health and the risk of endocarditis for individuals who do not have congenital heart disease have been further defined.
Patients with lesions associated with jet formation and