Cardiovascular disease Flashcards
4 questions to ask for patient with possible cardiovascular problems?
“Are you generally fit and well?”
“Do you have any heart problems?”
“Do you have high blood pressure?”
“What medications are you taking?”
What is a good way to check patients cardiovascular point?
Checking the patients exercise tolerance
Asking further questions such as, How far can you walk without stopping?
What prevents you from going further
General symptoms to look out for
- breathless at rest (may indicate heart failure/respiratory prob)
- sweaty or pained expression may indicate angina (chest pain) or myocardial infarction (heart attack)
Appearance of hands
Finger clubbing - congenital heart defect (prob with heart structure)
Pale nail bed - anaemia
Splinter haemorrhages - bacterial endocarditis (bacteria infection of inner layer of heart)
Appearance of face and oral cavity with patients of cardiovascular disease
Cyanosis (blue discolouration of lips/palate) - indicates poor oxygenated of blood, may have cardiac cause
Gingival hypertrophy - resulting from nifedipine antihypertensive medication
Xanthelasma (yellow plaques around eyes) - indicates elevated cholesterol
What is the difference between primary and secondary hypertension?
Primary = unknown cause to develop High blood pressure but most likely due to risk factors (smoking, lifestyle, overweight, stress) Secondary = known cause due to underlying medical condition (kidney disease, renal disease, pregnancy etc.)
In severe hypertension what can happen? and what can happen if untreated?
dizziness, headache
left ventricle failure, MI, stroke or renal failure
Meaning of systolic pressure on machine
Meaning of diastolic pressure on machine
pressure when heart pushes blood out
pressure when heart rests between beats
What is considered normal blood pressure ranges
systolic 90 - 120mmHg
diastolic 60 - 80mmHg
What can be done to help high blood pressure?
change in lifestyle : exercise, healthy eating, reduce stress, stop smoking/drinking
Hypertensive patients should be divided into 4 groups:
- Normotensive (normal BP)
- Controlled hypertensive (can be treated as normotensive patients but be aware of their medications taken)
- High BP detected in dental practice (should be referred for further investigation)
- Malignant hypertensive (HIGH risk 185/110mmHG should be urgently referred to doctor/hospital)
4 possible oral side- effects of antihypertensive drugs
- Xerostomia (diuretics)
- Gingival hyperplasia (nifedipine)
- Salivary gland swelling (clonidine)
- Altered taste (acetozolamide)
Dental relevance of hypertension
- Oral side affects
- May also be taking aspirin as part of management
- Increased postoperative bleeding
- Drug interactions between antihypertensive meds and drugs prescribed as part of dental treatment
- Increased risk of myocardial infarct and angina etc.
What is Ischaemic heart disease?
Imbalance between supply of blood to the heart muscle and demand
Most common cause of death in the western world
(build up of fatty substances narrowing/blocking the vessels supplying the heart - most likely due to unhealthy diet)
What is angina?
Attacks of chest pain due to reduced BF to the heart
