Cardiovascular diseases

Question 1

Define cardiovascular diseases.

Shed light on ischaemic heart diseases, coronary heart diseases and coronary artery diseases.

Answer 1

• CVD describes diseases of the heart and blood vessels

* Coronary heart disease, coronary artery disease or ischaemic heart disease are all the same thing

Question 2

List the types of cardiovascular diseases

Answer 2

• Hypertension
• Coronary artery disease
• Congestive heart failure
• Infective endocarditis
• Valvular defects
• Congenital heart disease
• Arrhythmias
• Rheumatic heart disease

Question 3

Describe hypertension

Answer 3

Too much force I exerted on arterial walls as blood is pumped through

Question 4

Describe rheumatic heart disease

Answer 4

Damage to heart valves due to rheumatic fever

Question 5

Describe coronary artery disease

Answer 5

Poor blood perfusion due to atherosclerosis

Question 6

Describe congestive heart failure

Answer 6

Condition in which the hearts function as a pump is inadequate to meet the body’s needs

Question 7

Describe infective endocarditis

Answer 7

Oral bacteria and other micro-organisms which cause inflammation of heart

Question 8

Describe valvular defects

Answer 8

Defects to one of the valves. Results in the mixing of oxygenated and deoxygenated blood

Question 9

Describe congenital heart disease

Answer 9

Patients born with cardiac abnormalities where oxygenated and deoxygenated blood mix

Question 10

Describe arrhythmias

Answer 10

Known as irregular heartbeat, bradycardia or tachycardia

Question 11

List the three causes of infective endocarditis

Answer 11

Self- induced bacteraemia

Infection at portals of entry

Trauma to tissue by instrumentation

Question 12

Describe the three causes of infective carditis

Answer 12

Self- induced bacteraemia
• Eating, bruxing, chewing gum or any activity (even interdental aids) that can force bacteria through wall of a diseased sulcus or pocket.

Infection at portals of entry
• Infections at sites where microorganisms may enter circulating blood
• Periodontal / gingival pockets
• Open area of infection (E.g. ulcer caused by ill-fitting denture)

Trauma to tissue by instrumentation
• Periodontal therapy / scaling
• General or oral surgery

Question 13

List instances where antibiotic prophylaxis is indicated for endocarditis

Answer 13

• Prosthetic valves
• Previous infective endocarditis
• Cardiac transplantation
• Rheumatic heart disease in Indigenous Australians and Maori and pacific Islander people
• Congenital heart disease but only if it involves:
o Unrepaired cyanotic defects
o Defects repaired with prosthetics material or devices 6 months after the procedure
o Repaired defects with residual defects near a prosthetic patch

Question 14

Discuss non-modifiable risk factors of cardiovascular disease

Answer 14

• Age
• Gender (males)
• Ethnicity
• Genetics
• Other diseases such as renal disease, endocrine disorders

Question 15

Discuss modifiable risk factors of cardiovascular disease

Answer 15

• Smoking
• High Cholesterol
• High Blood Pressure
• Diabetes
• Overweight
• Inactive
• Depression
• Excess salt (hypertension)

Question 16

Discuss cardiovascular disease and link to periodontal disease

Answer 16

• Periodontal treatment can improve endothelial function and other risk markers of atherosclerosis
• Lowering LDL-cholesterol by statins prevents or reduces periodontal disease
• Having periodontal disease increases risk of developing CHD
• Bacteria and pro-inflammatory cytokines involved n periodontal pathogenesis can enter into the bloodstream and result in CVD
• Bacterial entry causes a spike in C- Reactive proteins which causes inflammation.
• CRP predict risk of CVD and CRP levels reflect the severity of periodontitis

Question 17

Discuss the overall management of a patient with cardiovascular disease

Answer 17

• No periodontal treatment if systolic >180 and/ or diastolic >110 unless GP/ Dentist is consulted
• Reinforce the importance of maintaining high oral health
• Consult physician on whether there is a need for antibiotic prophylaxis prior to hygiene procedures
• 6 monthly check- ups