3. CVD - artherosclerosis, IHD, arrhythmias. Flashcards

1
Q

risk factors of atherosclerosis

A
  • family history of CVD
  • depression
  • DM
  • insulin resistance
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2
Q

what is artherosclerosis

A

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
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3
Q

artherosclerotic plaques can lead to

A

ischemia
thrombosis

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4
Q

artherosclerosis associated symptoms

A

chest pain

angina

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5
Q

isechemic heart ds is what

A

aka IHD
when you have an atherosclerotic plaque in the coronary arteries and then get complete blockage you get necrosis of the heart muscle.

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6
Q

IHD - Angina Pectoris symptoms

A
  • 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
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7
Q

IHD - Myocardial Infarction

A
  • 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
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8
Q

ISD: we __ require antibiotic prophylaxis for sbe

A

DO NOT

sbe= subacute bacterial endocarditis

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9
Q

if the pt had a recent myocardian infarction <1 month what can we do as dentists

A
  • urgent dental care ONLY with ACUTE dental pain or infection
  • consultation with physician
  • consider referral to specialized center
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10
Q

if pt has a past myocardial infarction more than a month since what can we do as dentist

A
  • consider the severity of the cardiac status and comorbities
  • ejection fraction to measure the degree of heart failure
  • consider appropriate managment protocols
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11
Q

what is ejection fraction

A
  • 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

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12
Q

IHD drug interactions and oral manifestations

A
  • same as HTN*
  • HLD, limit epinephrine like HTN (2 carts), and limit NSAIDS bleeding is as discussed earlier.
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13
Q

what are carotid atheromas

A
  • 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
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14
Q

what is the most common arrhythmia

A

atrial fibrillation

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15
Q

what is the most common cause of sudden cardiac death

A

ventricular fibrillation

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16
Q

causes of arrhythmias

A
  • cardiovascular disorders
  • pulmonary disorders
  • autonomic disorders
  • hyperthryoidism
  • drugs
  • electrolyte imbalance
  • anxiety and anger
17
Q

symptoms of arrhythmia

A
  • palpitations, fatigue
  • dizziness, syncope, angina
  • congestive heart failure
  • shortness of breath
  • orthopnea
  • peripheral edema
18
Q

atrial fibrillation includes

A
  • rapid uncontrolled artial activity
  • irregularlry irregular rhytm
  • risk of arterial clot formation (could caus embolism and stroke)
  • most common arrhythmia
19
Q

should you ever stop anticoagulants for dental tx

A

no. unless its an extensive surgery

20
Q

electrosurgery units are ___ in pt with pacemakers and ICDs

A

contraindicated

low risk for ultrasonic scalers and battery operated curing lights.

21
Q

what is the formula for INR:

A
22
Q

local measures for hemostasis/bleeding for an arrhythmia pt

A
  • gelatin sponge
  • oxidized cellulose
  • hemostatic products
  • sutures
  • gauze with applied pressure
  • topical tranexamic acid
  • topical aminocaproic acid
  • topical thrombin
  • electrocautery (not with pacemakers)