3. CVD - artherosclerosis, IHD, arrhythmias. Flashcards
(22 cards)
risk factors of atherosclerosis
- family history of CVD
- depression
- DM
- insulin resistance
what is artherosclerosis
the inflammatory disorder with accumulation of lipid plaque within the arterial walls. Asymptomatic process.
- we get thickened intima (decr. arterial lumen)
- decreased oxygen
- decreased blood flow to the myocardium
artherosclerotic plaques can lead to
ischemia
thrombosis
artherosclerosis associated symptoms
chest pain
angina
isechemic heart ds is what
aka IHD
when you have an atherosclerotic plaque in the coronary arteries and then get complete blockage you get necrosis of the heart muscle.
IHD - Angina Pectoris symptoms
- chest pain resultant from ischemic changes (mid-chest pain)
- pain may radiate (shoulder, arm JAW0
- pain lasts 5 to 15 mins (if unstable, may last longer)
- Vasodilation used to resolve angina
IHD - Myocardial Infarction
- irreversible coagulative necrosis of the myocardium (left ventricle is the most common MI), lose normal conduction and contraction
- symptomsa are similar to angina plus radiating features, sefvere substrenal pain with shortness of breath, profuse sweating, and loss of conciousness
- the pain does not resulve with vasodilators and is more prolonged
ISD: we __ require antibiotic prophylaxis for sbe
DO NOT
sbe= subacute bacterial endocarditis
if the pt had a recent myocardian infarction <1 month what can we do as dentists
- urgent dental care ONLY with ACUTE dental pain or infection
- consultation with physician
- consider referral to specialized center
if pt has a past myocardial infarction more than a month since what can we do as dentist
- consider the severity of the cardiac status and comorbities
- ejection fraction to measure the degree of heart failure
- consider appropriate managment protocols
what is ejection fraction
- it measure the amount (%) of blood that leafes the LV after contraction. Tell us basically how well the heart is pumping.
pumping ability of the heart being normal: 55 to 70%
anything below 40% is below normal
IHD drug interactions and oral manifestations
- same as HTN*
- HLD, limit epinephrine like HTN (2 carts), and limit NSAIDS bleeding is as discussed earlier.
what are carotid atheromas
- we get artherosclerotic plaques everywhere. like in the brain which can lead to stroke.
- Within a pano, sometimes around the carotid bifurcations we can see the mineralized bifucation around C4/C5
what is the most common arrhythmia
atrial fibrillation
what is the most common cause of sudden cardiac death
ventricular fibrillation
causes of arrhythmias
- cardiovascular disorders
- pulmonary disorders
- autonomic disorders
- hyperthryoidism
- drugs
- electrolyte imbalance
- anxiety and anger
symptoms of arrhythmia
- palpitations, fatigue
- dizziness, syncope, angina
- congestive heart failure
- shortness of breath
- orthopnea
- peripheral edema
atrial fibrillation includes
- rapid uncontrolled artial activity
- irregularlry irregular rhytm
- risk of arterial clot formation (could caus embolism and stroke)
- most common arrhythmia
should you ever stop anticoagulants for dental tx
no. unless its an extensive surgery
electrosurgery units are ___ in pt with pacemakers and ICDs
contraindicated
low risk for ultrasonic scalers and battery operated curing lights.
what is the formula for INR:
local measures for hemostasis/bleeding for an arrhythmia pt
- gelatin sponge
- oxidized cellulose
- hemostatic products
- sutures
- gauze with applied pressure
- topical tranexamic acid
- topical aminocaproic acid
- topical thrombin
- electrocautery (not with pacemakers)
