Which condition increases the risk for endocarditis and should be treated before surgery?

• A. Dental caries
• B. Hypertension
• C. Diabetes mellitus
• D. Hyperlipidemia

Answer: (A)

Oral infections can cause transient bacteremia with bacteria that are common causes of infective endocarditis. Dental caries reflect an active oral infection, and during surgery or even routine activities, bacteria from the mouth can enter the bloodstream and potentially seed damaged heart valves or prosthetic material. By treating the dental infection before surgery, you reduce this source of bacteria and lower the risk of developing endocarditis. The other conditions—hypertension, diabetes, and hyperlipidemia—are important for overall health and perioperative risk, but they do not directly introduce bacteria into the bloodstream to the same endocarditis risk in the surgical setting.