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Patient Care Exam 2 > 10/12: Cardiovascular Disease > Flashcards

10/12: Cardiovascular Disease Flashcards

1
Q

Studies have shown that approx. _______% of all patients in academic dental practices suffer from at least 1 chronic systemic disease

A

50%

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2
Q

What disease is the most prevalent?

A

Cardiovascular

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3
Q

What is the current survival rate of adult patients who experience cardiac arrest outside the hospital?

A

Less than 5%

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4
Q

How soon can warning signs and symptoms appear before arrests?

A

2 weeks

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5
Q

What is a symptom for men in cardiovascular disease?

A

Chest pain + flu like symptoms

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6
Q

What is a symptom for women in cardiovascular disease?

A

Shortness of breath + flu like symptoms

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7
Q

More than _____ million americans (about _____% of the population) are estimated to have some form of CD with about _____ million having coronary artery disease

A

70; 25%; 13

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8
Q

What is the mortality rate (pre covid) of people with CVD?

A

on the decline, 33%

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9
Q

What is the leading cause of death in the US after age 65?

A

CVD

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10
Q

What percentage of heart disease risk stems from genetic factors?

A

30%

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11
Q

Who is more at risk for development of coronary atherosclerotic heart disease at a younger age?

A

People with parents or siblings affected

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12
Q

Men develop heart disease ____ years earlier on average than women

A

10, especially with low testosterone, but women catch up post-menopausal

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13
Q

What race is more at risk for heart disease?

A

African americans

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14
Q

Why are african americans more at risk for heart disease?

A

Higher risk for hypertension

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15
Q

Majority of people who die of coronary disease are what age?

A

65 or older

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16
Q

What are risk factors for heart disease?

A

Smoking
Excessive alcohol use
Stress
Obesity
Diabetes
Cholesterol
Hypertension
Sleep apnea

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17
Q

What is the single most modifiable risk for cardiovascular disease?

A

Smoking

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18
Q

What are general warning signs and symptoms for heart disease?

A

Extreme fatigue
Constant dizziness or lightheadedness
Fast heart rate (more than 100bpm)
New, irregular heart beat
Chest pain
Difficulty breathing
Nausea and cold sweats
Edema

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19
Q

What is pitting edema?

A

Press on a swollen area and an indentation or pit remains

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20
Q

What is edema?

A

Fluid retention

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21
Q

What are the kinds of fluid retention (or edema)?

A

Mild
Severe (pitting)

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22
Q

What are the minor risk factors for cardiovascular disease?

A

Excessive alcohol use
Stress
Age

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23
Q

Narrowing or obstruction is called

A

Stenosis

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24
Q

What usually experiences stenosis?

A

Aortic valve

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25
Q

Stenosis can be caused by

A

Rheumatic fever
Calcification of valve
Vongenita abnormalities

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26
Q

What happens in dyspnea?

A

Breathing is difficult, labored, uncomfortable

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27
Q

Dyspnea is usually due to

A

COPD
Asthma

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28
Q

What happens in orthopnea?

A

Difficulty breathing when lying down

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29
Q

What are the causes of orthopnea?

A

heart failure, COPD, panic disorder, sleep apnea

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30
Q

This is caused by decreased or blocked blood flow to the heart due to plaque (cholesterol) build up

A

Coronary heart disease

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31
Q

What is a leading cause of morbidity and mortality in patients with diabetes?

A

Coronary heart disease

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32
Q

If you have diabetes, you are ______ as likely to have heart disease or stroke than someone who doesn’t have diabetes and at a younger age

A

twice

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33
Q

The longer you have diabetes, the more likely you are to have…

A

Heart disease

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34
Q

When you have cardiovascular disease and diabetes, you should manage your

A

ABCs

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35
Q

What are your ABCs?

A

A: regular A1c test and aim to stay in you target range
B. Keep blood pressure WNR
C: Manage cholesterol
S: Stop smoking

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36
Q

This is a disease caused by clogging of the arteries

A

Atherosclerosis

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37
Q

What is a major risk factors for atherosclerosis?

A

Elevation in serum lipid levels
Increased blood pressure

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38
Q

Is systolic or diastolic levels more strongly related to the incidence of CVD?

A

Systolic

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39
Q

SBP rises _______, and DBP tends to _______

A

throughout life; level off or decrease after the age of 50

40
Q

As atherosclerosis progresses, what can obstructed coronary arteries result in?

A

Diminished blood supply to the cardiac muscles

41
Q

What occurs when inadequate perfusion to the myocardium decreases oxygen delivery and clearance of tissue metabolites?

A

Transient, intermitted chest pain

41
Q

Is atherosclerosis progressive?

A

Yes

42
Q

What 3 things can chest pain cause?

A
  1. Angina pectoris
  2. Hyperventiliation
  3. Acute M.I
43
Q

What is the most common thing chest pain causes?

A

Angina pectoris

44
Q

What is the least common thing chest pain causes?

A

Acute M.I, pain is prolonged

45
Q

What is the most common reason of chest pain?

A

Hyperventilation

46
Q

What does angina pectoris result from?

A

Temporary ischemia of the myocardium

47
Q

What is the most important symptom of angina?

A

Chest pain

48
Q

What is described as a sensation of aching, heavy, squeezing pressure?

A

Angina

49
Q

What does angina result as?

A

Tightness in the midchest region

50
Q

The area of discomfort is reported to be the size of _____ and may radiate into _____________

A

Fist; left or right arm, neck or mandible

51
Q

How long is pain in angina pectoris?

A

Brief, lasting 5-15 minutes if the provoking stimulus is stopped

52
Q

What is the cause of angina pectoris?

A

Blood supply to the cardiac muscle is insufficient for oxygen demand (atherosclerosis or coronary artery spasm)

53
Q

Angina pectoris can be caused by

A

Atherosclerosis

54
Q

You can have hypertension in angina pectoris, but vitals are

A

Usually normal

55
Q

What can angina be observe in?

A

Absence of coronary obstruction-anemia, hypoxemia, or profound hypotension

56
Q

What can angina episodes be precipitated by?

A

Stress, anxiety, or physical activity

57
Q

What kind of angina is pain that is predictable, reproducible, unchanging and consistent over time. Pain is precipitated by physical effort (walking or climbing stairs, but can occur with eating or stress)

A

Stable angina

58
Q

What kind of angina may be confused for indigestion?

A

Stable angina

59
Q

Can stable or unstable angina pectoris be relieved with the use of nitroglycerin?

A

Stable angina

60
Q

Most patients with chronic stable angina have underlying

A

Coronary artery disease - plaques tend to be slow growing and relatively stable

61
Q

What angina is defined as new-pnset pain, increasing in frequency, and/or intensity, and is precipitated by less effort than before, can also occur at rest

A

Unstable angina

62
Q

What pain is not readily relived by nitroglycerin?

A

Unstable angina

63
Q

The key feature of changing character (increasing intensity, frequency) or pattern of pain in what kind of angina pectoris?

A

Unstable angina

64
Q

Patients with stable angina have what kind of prognosis?

A

Relatively good prognosis

65
Q

Patients with unstable angina have what kind of prognosis?

A

A poor prognosis and experience an acute MI within a short time

66
Q

When was nitroglycerine first noted?

A

1847 - “violent headache”

67
Q

Factory workers exposed to nitroglycerine coined the term?

A

“monday disease” when workers first exposed “sunday attacks”

68
Q

Nitroglycerin exerts action in how many minutes?

A

2-4 minutes

69
Q

Nitroglycerins duration of action is how many minutes?

A

30 min

70
Q

Side effects of nitroglcyerin?

A

Pounding in head
Tachycardia
Flushing
Possible Hypotension

71
Q

What should we do for someone with angina pectoris?

A

Stress reduction protocol
Avoid excess vasoconstrictors
Oxygen as necessary
Nitroglycerine tabs
- small bottle (plastic or metal, often keychain case)
- 1-2 tabs sublingual
4444 if doesn’t go away

72
Q

What is treatment for angina pectoris?

A

Place patient sitting up or semi-sitting position with head elevated
Ensure open airway and breathing is adequate
Check vitals
Dispense/administer nitroglycerin
Always check BP between each dose

73
Q

How much nitroglycerin should be administered for angina?

A

Repeat every 5 min up to 3 doses in 15 minute time period. Most only administer 2x

74
Q

When should you not give an additional dose of nitroglycerin?

A

If the systolic BP drops below 100mm/Hg because do not want to create profound hypotension and reflex tachycardia

75
Q

When should you give aspirin to someone with angina pectoris?

A

AFTER deciding no more nitroglycerin

76
Q

What medication is recommended for MI?

A

Aspirin, with 16-325 mg being CHEWED and swallowed to decrease platelet aggregation and limit thrombus formation

77
Q

What is myocardial infarction manifested as?

A

Crushing, squeezing or heavy feeling, that is more severe than with angina and lasting longer than 15 minutes; and is not relieved by nitroglycerin in a conscious patient

78
Q

What are signs of myocardial infarction?

A

Cyanotic, pale, or ashen appearance; weakness, cold sweat, nausea, vomiting, air hunger and impending death irregular pulse

79
Q

What is death of cardiac muscle due to?

A

Inadequate blood oxygen supply

80
Q

What does death of cardiac muscle progress to?

A

Cardiac arrest

81
Q

If a patient is over 8 weeks of treatment for post-myocardial infarction, what happens to dental treatment?

A

Can have elective treatment

82
Q

If a patient is less than 8 weeks out of treatment for post-myocardial infarcation, what happens to dental treatment?

A

No elective dental treatment

83
Q

What do you need to obtain when >8 weeks out of MI?

A

Medical consultation:
What is the patients cardiac status?
Is the patient’s cardiac condition stable?
What is the patients ejection fraction?
Does the patient have any degree of heart failure?

84
Q

Who should you not prescribe NSAIDs to?

A

A patient who has a history of MI because they increase the risk for subsequent MI

85
Q

What should a patients INR be on anticoagulants with MI?

A

2.0-3.0

86
Q

What are stress reduction protocol?

A

Short appt
Early morning appt
Nitrous oxide
Limit vasoconstrictors (<2 carpules)
Profound anesthesia
Explain everything “tell, show, do”

87
Q

What age does congestive heart failure occur?

A

> 65

88
Q

What results from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood?

A

Congestive heart failure

89
Q

What is not an actual diagnosis?

A

Congestive heart failure

90
Q

What is end stage of many CV diseases?

A

Congestive heart failure

91
Q

What are the signs and symptoms of CHF?

A

Fatigue and weakness
Ankle sweating (Edema)
Clubbing of the digits
Syncope (fainting)
Angina
Breathing difficulties
Increase night urination

92
Q

What is difficult/labored breathing?

A

Dyspnea

93
Q

What is sensation of breathlessness in the recumbent position?

A

Orthopnea

94
Q

What does sleeping with >2 pillows cause?

A

Labored caution

95
Q
A

Patient Care Exam 2 (5 decks)

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