A 37-year-old female with Turner's syndrome and repaired coarctation presents with a systolic ejection murmur and a diastolic blowing murmur. Which preventive measure does she require?

• A. Antibiotic prophylaxis against infective endocarditis
• B. Beta blocker therapy
• C. Chest CT
• D. Exercise stress test

Answer: (A)

Turner syndrome often comes with congenital heart defects such as bicuspid aortic valve and aortic coarctation. Even after surgical repair, these patients can have valvular abnormalities or residual defects that create a higher risk for infective endocarditis when bacteria enter the bloodstream. The presence of a systolic ejection murmur and a diastolic blowing murmur fits with valvular involvement (often bicuspid valve with regurgitation), which further elevates that risk. Because of this, preventive antibiotic prophylaxis before procedures that can cause bacteremia (most commonly dental work) is recommended to prevent endocarditis.

Other options don’t address this infection risk. Beta blocker therapy would target hemodynamic or arrhythmic issues, not endocarditis prevention. Chest imaging and exercise testing are diagnostic or functional assessments, not preventive measures for endocarditis.