Cardiovascular Disease

Question 1

Define cardiovascular diseases.

Shed light on ischaemic heart diseases, coronary heart diseases and coronary artery diseases.

Answer 1

• CVD describes diseases of the heart and blood vessels

* Coronary heart disease, coronary artery disease or ischaemic heart disease are all the same thing

Question 2

List the types of cardiovascular diseases

Answer 2

Hypertension

• Coronary artery disease
• Congestive heart failure
• Infective endocarditis
• Valvular defects
• Congenital heart disease
• Arrhythmias
• Rheumatic heart disease

Question 3

Describe hypertension

Answer 3

Too much force Is exerted on arterial walls as blood is pumped through

Question 4

Describe rheumatic heart disease

Answer 4

Damage to heart valves due to rheumatic fever

Question 5

Describe coronary artery disease

Answer 5

Poor blood perfusion due to atherosclerosis

Question 6

Describe congestive heart failure

Answer 6

Condition in which the hearts function as a pump is inadequate to meet the body’s needs

Question 7

Describe infective endocarditis

Answer 7

Oral bacteria and other micro-organisms which cause inflammation of heart

Question 8

Describe valvular defects

Answer 8

Defects to one of the valves. Results in the mixing of oxygenated and deoxygenated blood

Question 9

Describe congenital heart disease

Answer 9

Patients born with cardiac abnormalities where oxygenated and deoxygenated blood mix

Question 10

Describe arrhythmias

Answer 10

Known as irregular heartbeat, bradycardia or tachycardia

Question 11

List the three causes of infective endocarditis

Answer 11

Self- induced bacteraemia

Infection at portals of entry

Trauma to tissue by instrumentation

Question 12

Describe the three causes of infective carditis

Answer 12

Self- induced bacteraemia
• Eating, bruxing, chewing gum or any activity (even interdental aids) that can force bacteria through wall of a diseased sulcus or pocket.

Infection at portals of entry
• Infections at sites where microorganisms may enter circulating blood
• Periodontal / gingival pockets
• Open area of infection (E.g. ulcer caused by ill-fitting denture)

Trauma to tissue by instrumentation
• Periodontal therapy / scaling
• General or oral surgery

Question 13

List instances where antibiotic prophylaxis is indicated for endocarditis

Answer 13

• Prosthetic valves
• Previous infective endocarditis
• Cardiac transplantation
• Rheumatic heart disease in Indigenous Australians and Maori and pacific Islander people
• Congenital heart disease but only if it involves:
o Unrepaired cyanotic defects
o Defects repaired with prosthetics material or devices 6 months after the procedure
o Repaired defects with residual defects near a prosthetic patch

Question 14

Discuss non-modifiable risk factors of cardiovascular disease

Answer 14

• Age
• Gender (males)
• Ethnicity
• Genetics
• Other diseases such as renal disease, endocrine disorders

Question 15

Discuss modifiable risk factors of cardiovascular disease

Answer 15

Smoking
• High Cholesterol
• High Blood Pressure
• Diabetes
• Overweight
• Inactive
• Depression
• Excess salt (hypertension)

Question 16

Discuss cardiovascular disease and link to periodontal disease

Answer 16

• Periodontal treatment can improve endothelial function and other risk markers of atherosclerosis
• Lowering LDL-cholesterol by statins prevents or reduces periodontal disease
• Having periodontal disease increases risk of developing CHD
• Bacteria and pro-inflammatory cytokines involved n periodontal pathogenesis can enter into the bloodstream and result in CVD
• Bacterial entry causes a spike in C- Reactive proteins which causes inflammation.
• CRP predict risk of CVD and CRP levels reflect the severity of periodontitis

Question 17

Discuss the overall management of a patient with cardiovascular disease

Answer 17

-no perio treatment should be given to a patient with a systolic of >180 and diastolic of >110
- maintain a high level of OH
prior to treatment have the patient brush, rinse, flood with an antimicrobial rinse

Question 18

discuss oral complications of a patient with CVD

Answer 18

• Xerostomia
• burning mouth syndrome
• loss of taste
• lichenoid reactions
• gingival bleeding
• haematomas
• petechiae

Question 19

for hypertension describe systolic and diastolic pressure

Answer 19

systolic- occurs when blood pressure id pushed through the arteries by contraction of the heart

diastolic- occurs when the heart relaxes between beats

hypertension- excessive force is expected against the arterial wall as blood flows through

Question 20

list the 8 primary risk factors for hypertension

Answer 20

• tabacco use
• overweight
• hereditary
• race
• excessive salt in diet
• environment
• sex- men are more affected
• age

Question 21

state the 4 causes of secondary hypertension

Answer 21

• oral contraceptive
• renal disease
• endocrine disorders
• medications= decongestive and steroids

Question 22

state the 5 causes of congestive heart failure

Answer 22

• cardiac issue= value damage & abnormality in heart muscles
• precipitating causes= acute hypotensive crises, massive pulmonary embolism and arrhythmia
• drug therapy
• diet- excessive salt
• limitation of activity

Question 23

define valvular defect and state the 3 types

Answer 23

• the valvular defect is a result of oxygenated blood mixing with deoxygenated blood

1- ventricular defect= defects between ventricle the lower chamber of the heart that would normally pump blood to the body

2- atrial defect= defects between the upper chambers of the heart that would normally receive blood from the body

3- patient ductus arterious (PDA)= opening between two major blood vessels of the heart, usually closes shortly after birth. if ductus arterious remains open its referred to as patient ductus arterious (can close with medication by may require surgery )