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Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

pulmonary circulation

A

right side of the heart, which carries blood from the heart to the lungs and back to the heart

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2
Q

systemic circulation

A

left side of the heart, which carries blood from the heart to the rest of the body and then back to the heart

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3
Q

atherosclerosis

A

cells and lipids accumulate within the tunica intima not on the artery walls

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4
Q

hypertension can lead to

A

hypertiensive heart disease

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5
Q

two basic types of coronary heart disease

A

chronic ischemic heart disease
acute coronary syndromes

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6
Q

chronic ischemic heart disease

A

stable angina
silent myocardial ischemia

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7
Q

acute coronary syndromes

A

unstable angina
acute myocardial infarction
sudden death
ventricular fibrillation

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8
Q

coronary heart disease medication side effects

A

xerostomia
calcium channel blockers (gingival hyperplasia)
antithrombotic treatment regimen: anticoagulant/antiplatelet therapy (excessive bleeding)

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9
Q

peripheral artery disease

A

atherosclerosis of the arteries in the lower extremities

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10
Q

dental implications peripheral artery disease

A

if taking anticoagulants, know the coagulation status
side effects of other meds
patient education
evaluate for perio disorders
possible referral

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11
Q

abdominal aortic aneurysm

A

weakness of the aorta causing an enlargement or bulging of the artery
aneurysm located in abdominal aorta

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12
Q

abdominal aortic aneurysm dental implications

A

side effects of medications
stress importance of maintaining healthy oral tissue
identification of individual at risk may prompt a medical referral

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13
Q

raynaud disease or phenomenon pathogenesis

A

ischemia caused by vasospasm in the vessels of the extremities and sometimes ears and nose
brought on by cold or emotional stress
associated with smoking

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14
Q

raynaud disease or phenomenon dental implications

A

refer for medical evaluation
side effect of medications

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15
Q

thromboembolic venous disorders

A

formation of blood clots
can break away and lodge anywhere
deep vein thrombosis (DVT)

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16
Q

dental implications of thromboembolic venous disorders

A

low dose anticoagulant therapy (no risk of blood loss)
stronger anticoagulants (increase the risk of uncontrolled bleeding)
medical consultation to determine coagulation status
local hemostatic measures

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17
Q

common blood thinners

A

warfarin
eliquis
xarelto
pradaxa
heparin

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18
Q

2 forms of stroke

A

ischemic - thrombus/embolus
intracranial hemorrhage - trauma, hypertension, aneurysm

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19
Q

pathogenesis of stroke

A

blood obstructed by growing thrombus, or by an embolus
tissues distal to obstruction become damage and necrotic
resulting pressure in cranium due to blood flow causes an interruption of blood flow to tissues

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20
Q

perioral and intraoral characteristics after stroke

A

unilateral weakness may affect: chewing, swallowing, ability to clear the mouth of residual food
uncontrollable drooling
favor chewing on unaffected side of mouth
food pocketing
motor impairment

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21
Q

dental implications of stroke fall into four categories

A

management of side effects of meds
management of post stroke physical effects
home care modifications
emergency management of stroke

22
Q

dental implications of stroke - management of side effects of meds

A

determine coagulation status
provide local hemostatic measures
avoid tissue trauma
xerostomia management
calcium channel blockers may cause gingival overgrowth

23
Q

knowledge of heart disorders will enable the dental professional to

A

recognize potential problems
modify the treatment to protect the patient and provide the safest possible therapy

24
Q

shunts cause

A

mixing of oxygenated and deoxygenated blood

25
Q

ventricular septal defect

A

hole in septal wall between left and right ventricles causing mixing of blood
higher risk for infective endocarditis, aortic valve prolapse and blood clots
eventual congestive heart failure
clubbing of fingertips
fatigue, shortness of breath and tachycardia

26
Q

finger clubbing is an important feature with

A

chronic hypoxia
cyanosis

27
Q

atrial septal defect

A

hole in the wall between the right and left atria
cyanosis and hypoxia
abnormal heart beats (dysrhythmias)
clubbing of fingers
higher risk for infective endocarditis and emboli

28
Q

patent ductus arteriosus

A

ductus arteriosus does not close after birth
premature babies
heart murmur
development of pulmonary hypertension
higher risk for infective endocarditis and arteritis

29
Q

pulmonary stenosis

A

narrowing of pulmonary valve
caused by a fusion of the valve cusps
forming a funnel when the valve opens instead of a wide opening
if severe- will be difficult for the heart to pump blood into the lungs
CHF may result

30
Q

tetralogy of fallot (TOF)

A

4 defects: VSD, PD, overriding aorta, and right ventricular hypertrophy
right to left shunting of blood, cyanosis and hypoxia
shortness of breath
polycythemia - abnormal increase in the number of red blood cells
increased risk of infective endocarditis, emboli, brain abscesses, acute episodes of cyanosis during which seizures, loss of consciousness and sudden death are possible

31
Q

coarctation of the aorta (COA)

A

constriction of the aorta
BP and pulse in the upper body differs compared to the lower body
lower volume of blood is able to get past constriction
left ventricular hypertrophy, dizziness, headache, epistaxis
weakness, pain, pallor and coldness in lower extremities
arteritis at constriction site
untreated - increase risk for stroke, ruptured aortic and cerebral aneurysms, infective endocarditis at the aortic valve

32
Q

transposition of the great arteries (TGA)

A

aorta exits from right ventricle and pulmonary artery exits from left ventricle
most times also septal defect
if no septal defect to allow for mixing of blood then is fatal
cyanosis and hypoxia

33
Q

dental implications of congenital heart defects

A

presence of cyanosis should have medical investigation prior
treatment modifications - prophylactic antibiotics
supplemental oxygen
stress reduction techniques
caution administering local anesthetics
patients ed - link of oral infection and bacterial endocarditis
how adequate OH can decrease the risk of an autogenous infection

34
Q

dental antibiotic prophylaxis

A

antibiotic given to a patient for prevention of harmful consequences of bacteremia that may be caused by oral flora

35
Q

heart valve defects

A

narrowing of heart valves
muscles of heart have to compensate
insufficient heart valves do not close all the way, causing regurgitation
muscles will compensate to try to push more blood through
blood flow through valve is more turbulent causing more damage
heart eventually weakens and congestive heart failure will result

36
Q

two kinds of heart valve defects

A

benign/physiologic murmurs
pathologic murmurs

37
Q

pathologic murmurs

A

caused by valve defect
stenotic valves - symptoms manifest when the heart is under stress
shortness of breath, possible chest pains

38
Q

benign/physiologic murmurs

A

mostly heard in small children
grow out of, no treatment needed
no risk for endocarditis

39
Q

heart valve defects dental implication

A

daily home care could cause bacteremia
bacteria within the blood to attach to endocardium
no prophylactic antibiotics for physiologic heart murmurs
anticoagulant therapy (xerostomia)
individuals with valve replacement are at a high risk for bacterial endocarditis and thrombus formation (may be on prophylactic antibiotics, augmented antibiotic prior to, consultation with patient’s physician)

40
Q

mitral valve prolapse dental implications

A

the ADA no longer requires prophylactic antibiotic coverage with or without regurgitation
education should be given to patients on the importance of decreasing the risk of creating a bacteremia that might result in infective endocarditis

41
Q

rheumatic heart disease dental implications

A

patients may be on anticoagulants
patients may be on daily antibiotics
should be suspected for patients reporting a history of rheumatic fever (at risk for recurrence, which could cause more heart damage)

42
Q

infective endocarditis etiology

A

bacteria (staphylococcus and streptococcus)
gram negative bacillus, yeast, fungi
bacteremia must be present
can form in a healthy heart, but develops most often in a heart compromised

43
Q

infective endocarditis peri/intraoral characteristics

A

petechiae may be found on any of the oral mucosal surfaces, especially soft palate and buccal mucosa

44
Q

infective endocarditis extraoral characteristics

A

fever, chills, shortness of breath, could have low grade fever and flu like symptoms

45
Q

dental implications of infective endocarditis

A

prophylactic antibiotics prior to dental treatment
gingival and periodontal infections are the most common source of transient bacteremia
identify persons at risk

46
Q

congestive heart failure perioral and intraoral characteristics

A

cyanosis of the lips and oral tissues
severe: right side jugular vein may become distended and can be observed when patient is in an upright position

47
Q

dental implications of congestive heart failure

A

xerostomia because of medications for CHF
modifying the chair to a semi-upright or upright might be indicated as well as supplemental oxygen to aid in breathing

48
Q

dysrhythmias

A

abnormal heart rhythms or beats

49
Q

tachycardia

A

fast heartbeat

50
Q

bradycardia

A

slow heartbeat

51
Q

dental implications of dysrhythmias

A

often able to identify abnormal heart rhythms
refer to physician
implanted pacemakers or defibrillators do not indicate the need for prophylactic antibiotic coverage
careful using magnetostrictive devices around unipolar pacemakers
bipolar and ICD

Pathology (12 decks)

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