2. Cardiovascular Disease 1

Question 1

Heart failure classification class I

Answer 1

• physical activity: no limitation

no dyspnea, fatigue or palpitations with physical activity

Question 2

Heart failure classification class II

Answer 2

• physical activity: slight limitation

fatigue, dyspnea, palpitations with physical activity

Question 3

Heart failure classification class III

Answer 3

• physical activity: market limitations

less than normal physical activity results in symptoms. Comfortable at rest.

Question 4

Heart failure classification class IV

Answer 4

• physical activity: severely limitations

symptoms present at rest.

Question 5

signs of cardiovascular ds

Answer 5

• elevated bp
• irregular or abnormal heart rate
• abnormal respiratory rate
• shortness of breath upon exertion
• prolonged bleeding/easy bruising
• surgical scars

Question 6

symptoms of cardiovascular ds

Answer 6

• pt is uncomfortable in supine position.

Question 7

what is in a low level intervention

Answer 7

• health/medical evaluation
• exams
• prophy
• XR
• optical oral scans
• alginate impression

Question 8

what are moderate interventions

Answer 8

• SRP, any scaling
• simple restorative procedures (1 to 2 teeth)
• Simple extractions (1-2 teeth)
• restorative impressions needing retractions and longer setting times.

Question 9

what are high risk intervention

Answer 9

• complex restorative procedure on two or more teeth
• multiple extractions
• surgical extractions
• implant placement
• full arch impression (bc these are stressful)
• dental care under general anesthesia.

Question 10

aldosterone maintains

Answer 10

the physiologic BP when BP is low

Question 11

primary and secondary HTN differences

Answer 11

primary: multifactorial, gene-environment
90-95% of cases

secondary: renal ds and renin producing tumors, cardiovascular, neurologic, endocrine.

Question 12

for a HTN pt what re the goals

Answer 12

between <130-149/80 - 90 mmHg

but can depend on pt age adn comorbidities.

Question 13

HTN medical management of lifestyle modifications

Answer 13

• diet (increasing fruit intake, decreasing Na+, increased K+)
• physical exercise/weight loss
• tobacco cessation and alcohol intake reduction

Question 14

HTN oral manifestations

Answer 14

none of the oral manifestations are due to HTN itself.

they are all side-effects of pharmacotherapy

Question 15

HTN side effects of pharmacotherapy

Answer 15

• dry mouth
• burning mouth
• taste changes
• angioedema
• gingival hyperplasia
• lichenoid reactions
• lupus-like lesions

Question 16

dental considerations for the HTN pt

Answer 16

• severe complications of uncontrolled HTN such as stroke, angina, arrhythmia, MI
• stress, anxiety fear can increase BP and lead to S.A.A.M.
• the use of a vasoconstrictor (like epi) can cause an acute rise in BP for pt taking non-selective beta-blockers
• orthostatic hypotension, with sudden changes to pt positioning.

Question 17

for HTN patients, we want to limit the amount of stress for the pt, what are some ways we can do this in the chair

Answer 17

• oral and/or inhalation sedation

-profound anesthesia

• limit to 2 epi, do not use epi-gingnival retraction cord
• avoid some antibiotics and long term NSAIDS.

Question 18

general guidelines for a medical consult you want to ask what

Answer 18

very specific questions to the physician in relation to the current ds status of the pt.

and the benefits must outweight ds risk

Question 19

the time of the procedure ______ to the risk category

Answer 19

directly proportional

Question 20

what are the cardiac measures to be taken with HTN pt

Answer 20

• • stress reduction protocol
• • nitrous oxide
• • profound anesthesia
• • cardiac epi dose of max 0.04mg
    
    • articaine for max blocks and max or md infiltrations
    • 2% lidocaine 1:100,00 epi for IANB
    • 3% mmepivacaine without epe for anesthesia.