Cardiac Electrophysiology Consultants of South Texas, P.A.

Medical Center Tower I
7950 Floyd Curl Drive
Suite 803
San Antonio, TX 78229
tel: 210-615-9500
fax: 210-615-9600
email: office at cecst.com
 Specializing in the compassionate care of people who suffer from abnormalities of the electrical system of the heart Current Insurance Plans: We accept most major commercial insurance plans. Please call for details.
Medicare: We have opted out of Medicare, and are happy to care for Medicare beneficiaries on an affordable cash basis. Note: Federal law prohibits signing the Federally-mandated opt-out contract with a Medicare beneficiary who is in an emergency situation.
No insurance? No problem! Consider our affordable Fee for service (direct pay).
Home of the Original Personalized Medical Office SystemTM released April 5, 2013

General information about the heart for patients, their family members, and concerned laymen

Antibiotic Prophylaxis to Prevent Endocarditis
     The routine use of antibiotics before dental procedures was thought necessary when various structural abnormalities of the heart were present. However, in 1997, the guidelines for this use of antibiotics were revised. The full guidelines can be found here and minor changes in the wording published as a Correction can be found here. The 1997 revision was based on the observation that the risk of endocarditis (infection of the inner lining of the heart, most commonly of the heart valves) was increased during only dental procedures and only in patients who had the most severe structural abnormalities. As a result, most patients do not need to take antibiotics for the purpose of preventing endocarditis before dental procedures, and no patients need to take antibiotics for this purpose before genitourinary or gastrointestinal tract procedures.

The cardiac conditions associated with the highest risk of adverse outcome from endocarditis for which prophylaxis with dental procedures is reasonable are:

  • Prosthetic cardiac valve or prosthetic material used for cardiac valve repair
  • Previous infectious endocarditis
  • Congenital heart disease (CHD)*
    • Unrepaired cyanotic CHD, including palliative shunts and conduits
    • Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure**
    • Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
  • Cardiac transplantation recipients who develop cardiac valvulopathy

*Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of CHD.
**Prophylaxis is reasonable because endothelialization of prosthetic material occurs within 6 months after the procedure.


Dental procedures for which endocarditis prophylaxis is reasonable include all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. The following procedures and events do not need prophylaxis: routine anesthetic injections through noninfected tissue, taking dental radiographs, placement of removable prosthodontic or orthodontic appliances, adjustment of orthodontic appliances, placement of orthodontic brackets, shedding of deciduous teeth, and bleeding from trauma to the lips or oral mucosa.


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