Explain Endocarditis
The risk of endocarditis is considered high in patients with last bacterial endocarditis, prosthetic heart valves, complex cyanotic congenital heart disease like tetralogy of Fallot, or surgically constructed systemic pulmonary shunts or conduits. The risk is considered sufficient to justify prophylaxis in patients with other forms of congenital cardiac malformation (but not isolated secundumatrial septal defect), acquired valvular disease (like rheumatic), hypertrophic cardiomyopathy, and mitral valve prolapse with thickened leaflets or regurgitation.