SPECIAL CARE cardiac conditions Flashcards
(28 cards)
what is a congenital cardiac condition?
any congenital structure defect of the heart or adjacent great vessels
give an example of a cyanotic congenital cardiac condition?
Tetralogy of Fallot
give an example of an acyanotic congenital cardiac condition?
ventricular septal defect
what are the oral findings you may see in people with heart conditions?
delayed eruption of both dentitions
increased positional abnormalities
enamel hypoplasia
vasodilation of pulp
increased periodontal disease
increased caries
what are the dental considerations for pts with heart conditions?
bleeding tendency?
anticoagulated?
risk of infective endocarditis?
hypertension with adrenaline containing products?
hypertension associated with dental tx/ environment?
associated issues - learning disabilities/ cleft palate?
what guidelines are available for risk assessing infective endocarditis?
NICE 2016
SDCEP 2018
what are the types of pts in the special consideration sub group at increased risk of IE?
- prosthetic valve
- previous episode of IE
- congenital heart disease: any cyanotic CHD, any type of CHD repaired with a prosthetic material
what is ischaemic heart disease?
result of progressive myocardial ischaemia due to persistently reduced coronary blood flow
what causes ischaemic heart disease?
atherosclerosis and hypertension
atherosclerosis is linked to:
- smoking
- lack of exercise
- obesity
what are types of ischaemic heart disease?
angina
and/ or myocardial infarction
what are the oral adverse effects of drugs used to manage ischaemic heart disease?
lichenoid reactions
gingival swelling
angioedema
mucosal ulceration
what are the dental considerations for pts with unstable angina?
treat in acute hospital setting
what are dental considerations for pts with angina?
frequency of angina attacks?
when was last attack? what happened? precipitating factors?
stable or unstable/
what to consider when planning a dental appointment for an angina patient?
dental tx may precipitate an angina attack therefore:
- keep appts short and stress free
- consider timing of appts
- monitor BP and SP02?
- pre-op GTN?
- fully supine may cause patient distress
when should dental tx be deferred post MI?
6 months
what is hypertension?
BP consistently over 140/90mmHg
cause of hypertension?
unknown
hypertension treatment?
- lifestyle changes
- diuretic
- B blocker
- Statins
- aspirin/ clopidogrel
what are the oral side effects of drugs used to treat hypertension?
- xerostomia
- salivary gland pain/ swelling
- lichenoid reactions
- angio-oedema
- gingival hyperplasia
- sore mouth
- paraesthesia
can you treat someone with uncontrolled hypertension?
no, refer to GMP and defer dental tx
what is cardiomyopathy?
a group of conditions that affect the structure of the heart muscle and its ability to pump blood around the body
treatment for cardiomyopathy?
- B blockers, anticoagulants, diuretics
- pacemakers or Implantable cardioverter defibrillator (ICDs)
- surgery
- transplant
what dental devices may interfere with somenes pacemaker?
diathermy
US scalers
EPTs
what happens during a dental assessment pre heart surgery?
- follow local protocol
- extract teeth affected by severe perio, gross caries, apical path, grade 2/3 mobility
- antibiotic cover (follow guidance)
