Cardiovascular Disease

Question 1

Risk factors for heart disease

Answer 1

heredity, sex, race, age(65 or older)

Question 2

Sex differences

Answer 2

men develop 10 years earlier than women, esp with low testosterone. women catch up after postmenopausal

Question 3

Race difference

Answer 3

African Americans are more at risk. Hispanics are 25% less likely than whites.

Question 4

General warning signs and sympotoms

Answer 4

Extreme fatigue
- constant dizziness or lightheadedness
- fast heart rate- exception is angina pectoris
- new, irregular heartbeat-exception is angina pectoris
Chest pain
difficulty breathing
nausea 
edema (ankles)

Question 5

Edema

Answer 5

Fluid retention

-mild or severe (pitting)

Question 6

Major risk factors for CV

Answer 6

Smoking
Diabetes
Cholesterol
Hypertension
Obesity
Sleep apnea
Family hx

Question 7

Minor risk factors for CV

Answer 7

Excessive alcohol use
stress
age

Question 8

Chest pain can cause

Answer 8

angina pectoris - most common
hyperventilation
acute MI

Question 9

Angina Pectoris

Answer 9

Chest pain
Described as a sensation of aching, heavy, squeezing pressure
highness in the midcoast region
Area of discomfort often is reported to be the size of a fist and may radiate into the left or right arm, neck or mandible
Pain is of brief duration, lasting 5-15 min if the provoking stimulus is stopped

Question 10

Cause of angina pectoris

Answer 10

Blood supply to the cardiac muscle is insufficient for O2 demand (atherosclerosis or coronary artery spasm)
episodes may be precipitated by stress, anxiety, or physical activity
vital signs are normal, no hypotension, sweating or nausea occur

Question 11

Stable Angina

Answer 11

Pain that is predictable, reproducible, unchanging and consistent over time. Pain typically is precipitated by physical effort like walking
May be confused or indigestion
pain is relieved by cessation of the precipitating activity,, by rest or the use of nitroglycerin

Question 12

Unstable Angina

Answer 12

New-onset pain, increasing in frequency and/or intensity, and is precipitated by less effort than before - can occur at rest
pain is not readily relieved by nitroglycerin
key feature is the changing character (increasing intensity) or pattern of pain

Question 13

Nitroglycerin

Answer 13

exerts action in 2-4min
duration of action 30 min
side effects include
- pounding in head
- flushing
- tachycardia 
- possible hypotension

Question 14

Angina pectoris - management

Answer 14

stress reduction protocol
avoid excess vasoconstrictors
O2 needed
nitroglycerine tabs 
- small bottle 
- 1-2 tabs sublingual 
911 if it doesn't go away

Question 15

Angina pectoris - treatment

Answer 15

Place pt in sitting-up or semi position with head elevated
ensure open airway
check vitals
dispense/administer nitroglycerin either tablet or spray sublingually - repeat every 5 mints up to 3 dose in a 15 min period
always check BP at each dose - systolic drop below 100 do not give anymore
if pain it not relieved, give 1 aspirin 325 mg and call 911

Question 16

Myocardial Infarcation

Answer 16

Sexs report different symptoms w/ fewer women experiencing chest pain but more often experiencing fatigue and dyspnea
pt who have experienced an acute MI should be hospitalized or receive emergency treatment as soon as possible
basic management goal is to minimize the size of the infarction and prevent death from lethal arrhythmias
early administration of aspirin with 160-325 mg being chewed and swallowed to decrease platelet aggregation and limi thrombus formation

Question 17

MI signs and symptoms

Answer 17

development of chest pain, manifested as a crushing, squeezing or heavy feelings the tis more sever than with agina and lasting longer than 15 min; and is not relieved by nitroglycerin in a conscious patient
cyanotic, pale, or ashen appearance; weakness, cold sweat, nausea, vomiting, air hunger and sense of ‘impending death’ irregular pulse
death of cardiac muscle due to inadequate blood o2 supply
the condition may progress to cardiac arrest
with unresponsive pt-initate CPR, including use of automated external defibrillator (AED)

Question 18

Acute MI

Answer 18

heat attack
lack of o2 to tissue causes ischemia (damage)
4-6 hours = permanent damage (necrosis)
if plaque ruptures can result in thrombus (blood clot) formation

Question 19

MI and dental

Answer 19

Treatment post MI
<8 weeks out, no elective dental treatment
> 8 weeks out, elective dental treatment possible need to: obtain medical consultation