Cyanotic CHD IE Risk — MFDS Part 1 MCQ

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HardHuman DiseaseCyanotic CHD IE RiskMFDS Part 1

According to current SDCEP infective endocarditis risk stratification, which congenital cardiac history places a patient in the high-risk category rather than the moderate- or low-risk category?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Cyanotic congenital heart disease palliated with a systemic-to-pulmonary shunt

Explanation lettering: C = shown as A · A = shown as C · E = shown as D · D = shown as E

A is correct. Current SDCEP advice places cyanotic congenital heart disease treated with postoperative palliative shunts, conduits or other prostheses in the high-risk infective endocarditis category. A bicuspid aortic valve without prosthetic repair is categorised as moderate risk. Isolated atrial and ventricular septal defects are low-risk conditions. Prosthetic material used to close a septal defect confers high risk during the first 6 months after implantation; therefore, a completely repaired VSD 8 months previously, with no residual shunt, is no longer in the high-risk category. Risk classification should not be confused with an automatic indication for antibiotic prophylaxis: any prophylaxis decision also depends on the planned dental procedure and current SDCEP recommendations.

Reference: Scottish Dental Clinical Effectiveness Programme. Antibiotic Prophylaxis Against Infective Endocarditis, Second Edition: High risk patients and Glossary of cardiac terms. 2026. https://www.antibioticprophylaxis.sdcep.org.uk/implementation-advice/patients-at-risk-of-infective-endocarditis/high-risk-patients/