Q: Which of the following disease may require prophylaxes for both thromboembolism and infective endocarditis?

A) Deep Venous Thrombosis
B) Obstructive hypertrophic cardiomyopathy 
C) Acute saddle Pulmonary Embolism
D) Mitral prolapse
E) Sickle Cell disease



Answer:  B

Out of all the diseases, obstructive hypertrophic cardiomyopathy may require both prophylaxes. As patients with obstructive hypertrophic cardiomyopathy are prone to develop atrial fibrillation, prophylactic anticoagulation is recommended. Though official guidelines don't recommend antibiotic prophylaxis in these patients against infective endocarditis, data suggests and favor practice of antibiotic prophylaxis in such patients before dental or any invasive procedure.


References: 

1.  Pasquale G Di, Andreoli A, Lusa AM, et al. Cerebral embolic risk in hypertrophic cardiomyopathy. In: Advances in Cardiomyopathies, Baroldi G, Camerini F, Goodwin JF (Eds), Springer-Verlag, 1990. p.90. 

2. Spirito P, Rapezzi C, Bellone P, et al. Infective endocarditis in hypertrophic cardiomyopathy: prevalence, incidence, and indications for antibiotic prophylaxis. Circulation 1999; 99:2132.