Table 4.

Case Examples

Case	Category	Advice (also use clinical judgment)
A 17‐y‐old boy has moderate mitral stenosis, mild aortic insufficiency, and normal ventricular function who is taking medications and does not currently have symptoms	Low risk	Continue BPG
A 16‐y‐old girl taking warfarin after mitral valve replacement 1 y ago, currently with normal ventricular function and asymptomatic	Low risk	Continue BPG
A 14‐y‐old patient with moderate mitral stenosis and normal ventricular function who has marked breathlessness with light walking to school	Elevated risk (symptomatic— NYHA class III)	Consider oral prophylaxis
An 18‐y‐old patient with severe mitral stenosis and mild symptoms who is awaiting surgery	Elevated risk (severe mitral stenosis)	Consider oral prophylaxis

BPG indicates benzathine penicillin G; and NYHA, New York Heart Association.