From the Research
Cardiomegaly by itself does not require prophylactic antibiotics, as it is not an infectious condition but rather a structural change in heart size that can result from various underlying causes. The appropriate treatment for cardiomegaly focuses on addressing the underlying cause rather than using antibiotics. The only exception would be if the cardiomegaly is associated with certain specific cardiac conditions that independently warrant antibiotic prophylaxis, such as prosthetic heart valves or certain congenital heart defects, particularly before dental or invasive procedures, as suggested by recent guidelines 1. In these cases, the antibiotic prophylaxis is recommended because of the specific cardiac condition, not the cardiomegaly itself. Management of cardiomegaly typically involves:
- Medications to reduce heart workload
- Control blood pressure
- Improve heart function
- Lifestyle modifications such as sodium restriction, regular exercise, and weight management. According to the most recent and highest quality study, antibiotic prophylaxis is recommended only for individuals at high risk of infective endocarditis 1. It is essential to note that cardiomegaly itself is not a condition that requires antibiotic prophylaxis, and the focus should be on managing the underlying cause of the condition, rather than using antibiotics as a preventative measure, as also supported by other studies 2, 3, 4.