Atherosclerosis, IHD and Arrhythmias

Question 1

The following are side effects of meds that are used to treat _______:
➢Dry mouth is often synergistic with burning mouth
➢Lichenoid reactions (may have a “burning” symptom)
➢Gingival hyperplasia
➢Angioedema
➢Taste changes
➢Lupus type lesions

Answer 1

Hypertension

Question 2

Serious potential complications of severe uncontrolled HTN:

Answer 2

• Stroke
• Angina
• Arrhythmia
• Myocardial infarction

Question 3

• Inflammatory disorder with accumulation of
lipid plaque within the arterial walls
➢ Thickened intima (decreased arterial lumen)
➢ Decreased oxygen
➢ Decreased blood flow to the myocardium
• Leads to
➢ Stenosis
➢ Angina (stable ischemic disease)
➢ MI
➢ Ischemic stroke (acute ischemic disease)
➢ Peripheral arterial disease

Answer 3

Atherosclerosis

Question 4

• Associated symptoms 
➢ Chest pain
➢ Angina 
• Complications
➢ Unstable angina 
➢ Myocardial infarction (necrosis)
➢ Thrombosis
➢ Embolism
➢ Aneurysm

Answer 4

Atheroscleorsis

Question 5

• Chest pain resultant from ischemic changes  
➢Mid-chest pain described as
o“aching, heavy squeezing pressure or tightness”
• Pain may radiate 
➢Shoulder, arms, jaw
• Pain lasts 5-15 minutes
➢ If unstable angina, may be longer
• Vasodilation used to resolve

Answer 5

Angina pectoris

Question 6

_____ angina pectoris
➢Imbalanced cardiac perfusion
➢Stable symptoms, reproducible, predictable, consistent
➢Chest pain precipitated by physical activity/exertion
➢Resolves with cessation of activity

Answer 6

• Stable angina pectoris

Question 7

_____ angina pectoris
➢Disruption of atherosclerotic plaque
➢Possible partial thrombosis, embolism or vasospasm
➢Symptoms increasing
➢Chest pain at rest or with less intense physical activity/exertion

Answer 7

• Unstable angina pectoris

Question 8

• Irreversible coagulative necrosis of the myocardium
➢Lose normal conduction and contraction
➢Left ventricle MI more common
• Symptoms similar to angina, plus
➢Radiating features
➢Severe substernal pain with shortness of breath, profuse sweating,
and loss of consciousness
• Pain does not resolve with vasodilators and is more prolonged

Answer 8

Myocardial Infarction

Question 9

HMG-CoA reductase inhibitors/ statins are used for patients with _______

Answer 9

Hyperlipidemia

Question 10

For most general dental procedures, do you take them off antiplatelet therapy?

Answer 10

No leave on blood thinners

Question 11

\_\_\_\_\_\_\_ can measure the 
degree of heart failure
➢Measures amount (%) of blood that 
leaves the left ventricle after 
contraction.

Answer 11

Ejection Fraction

Question 12

An ejection fraction below ___ is considered bad and not getting better in response to CVd

Answer 12

40%

Question 13

• Primary pacemaker
• Regulates atrial function
• Produces P wave (atrial depolarization)

Answer 13

SA node

Question 14

• Regulates atrial impulses entering
ventricles
• Slows conduction rate of SA generated
impulses

Answer 14

AV node

Question 15

• Simultaneous depolarization of the

ventricles

Answer 15

QRS complex

Question 16

• Repolarization of the ventricles

Answer 16

T wave

Question 17

• depolarization of the atria

Answer 17

P wave

Question 18

Disruption of the electrical impulse generation or conduction in the heart that
leads to abnormal cardiac function
• Formation of abnormal impulse
• Increased impulse formation
• Enhanced or abnormal impulse formation
• Delayed depolarization
• Re-excitation of the heart after refractory period
The disruption may be due to an area of:
• Infarction
• Ischemia
• Electrolyte imbalance
• Medication
The most common cause of sudden cardiac death is ventricular fibrillation

Answer 18

Arrhythmia

Question 19

The most common cause of sudden cardiac death is _________

Answer 19

ventricular fibrillation

Question 20

The most common arrhythmia is ______

Answer 20

Atrial fibrillation

Question 21

Causes of \_\_\_\_\_
• Cardiovascular disorders 
  • Myocardial infarction
  • Mitral stenosis
  • Valvular disease
  • Ischemic heart disease
  • Congestive heart failure
  • Pulmonary disorder
➢Pneumonia
➢Obstructive lung disease
• Autonomic disorder
• Hyperthyroidism
• Drugs 
➢ Epinephrine
➢ Alcohol
➢ Digitalis
➢ Morphine
➢ Beta-blockers
➢ Tricyclic antidepressants, and 
others
• Electrolyte imbalance 
• Anxiety and anger

Answer 21

arrhythmias

Question 22

• Most common arrhythmia 
• Rapid uncontrolled atrial activity
• Irregularly irregular rhythm 
• Risk of arterial clot formation
➢ Embolism and stroke

Answer 22

Atrial Fibrillation

Question 23

T/F: NEVER STOP ANTICOAGULATION FOR DENTAL TREATMENT

UNLESS EXTENSIVE SURGERY

Answer 23

True

Question 24

Can you do electrosurgery on a pt with arrhythmia?

Answer 24

Never