| HIGH RISK (PROPHYLAXIS RECOMMENDED) | MEDIUM RISK (PROPHYLAXIS RECOMMENDED) | NEGLIGIBLE RISK (PROPHYLAXIS NOT RECOMMENDED) |
| Prosthetic cardiac valves, including bioprosthetic and homograft valves | Most congenital cardiac malformations that are not high or negligible risk | Isolated secundum atrial septal defect |
| Previous bacterial endocarditis | Acquired valvar dysfunction (eg, rheumatic heart disease) | Surgical repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosus (without residua beyond 6 mo) |
| Complex cyanotic congenital heart disease (eg, single ventricle states, transposition of the great arteries, tetralogy of Fallot) | Hypertrophic cardiomyopathy | Previous coronary artery bypass graft surgery |
| Surgically constructed systemic pulmonary shunts or conduits | Mitral valve prolapse with valvar regurgitation and/or thickened leaflets | Mitral valve prolapse without valvar regurgitation |
| | Physiologic, functional, or innocent heart murmurs |
| | Previous Kawasaki disease without valvar dysfunction |
| | Previous rheumatic fever without valvar dysfunction |
| | Cardiac pacemakers (intravascular and epicardial) and implanted defibrillators |