Cardiovascular Systme Flashcards
Acute Rheumatic fever is a disease of – or –
childhood or adolescence
Prevention of recurrent rheumatic fever depends upon the continuous low-dose of –
prophylactic antibiotics
Patients with rheumatic heart disease are not at risk to – and dont need a –
dental treatment bacteremia
premed
Patients with Rheumatic heart disease are at risk for – caused by physiologic bacteremia but the risk is minimized in patients with good oral hygiene.
endocarditis
If endocarditis is suspected patients should be referred for –
medical eval and treatment
what are the signs and symptoms for endocarditis?
fever, murmur, chills, sweats, nausea, vomiting, weight loss, septic emboli, confusion.
A myocardial infarction is another word for –
heart attack
What results from inadequate coronary blood supply due to the occlusion of the coronary arteries by an emboli or thrombi?
heart attack
What are the sympotoms of a sudden heart attack?
sudden onset of substernal pain that might radiate to neck and arms. Also rapid pulse and low blood pressue
No elective dental care should be given on patients who had a heart attack within a — time frame
4-6 week
A medical consult is suggested for all patients with a history of heart attack to –
confirm meds and the patients status
The use of – should be minimized in patients who have heart attacks.
vasoconstrictors
What anticoagulant is a concern because of its effect on clotting?
warfarin
What is the normal prothrombin time?
11-15 seconds
what is a normal INR?
1
what is the cut off INR for treatment??
3.5 and below
what INR are patients on warfarin at?
2.5-3.5 to prevent heart attack
What if a patient has a INR of greater than 3.5?
send them to the doc to get dosage reduced and wait 3-5 days
What occurs when the heart is no longer able to circulate an adequate amount of blood to the body tissues?
congestive heart failure
What are the symptoms of congestive heart failure?
shortness of breath, fatigue, chest pain, blood lips/tongue/mucosa.
Patients with poorly controlled symptoms of congestive heart failure should not receive routine dental care until…
medication has been provided for treatment
Patients with congestive heart failure are usually unable to tolerate a – or – chair position.
supine or semisupine
Use of – should be limited with patients with congestive heart failure.
vasoconstrictors
What is a sign of coronary artery disease?
angina
what is angina?
brief chest pain
Angina is a lack of – to the myocardium
oxygen
What is a common drug for angina?
nitroglycerin or other vasodilators.
What causes angina pain?
exercise, emotion, or heavy meal
Patients with severe or progressive angina should have minimized use of – and –
local anesthetics containing vasoconstrictors.
What occurs when there is a shortage of blood to the brain?
stroke
what efforts should be made for patients with a history of stroke?
minimize stress, and get them to breathe normally.
— should be minimized in stroke patients
vasoconstrictors
What is caused by a turbulence of blood flow producing vibratory sounds during the beating heart?
heart murmur
What kind of heart murmur occurs in the absence of any pathologic change in the structure of the heart or valvues?
functional heart murmur
What type of murmur occurs when there is a structural change or damage to the heart or valves?
organic or pathologic murmur
The presence of a organic heart murmur may predispose patients to –
bacterial endocarditis infection
Patients with murmurs of unknown origin should be referred to –
evaluate need for meds or treatment
What are the group of genetically determined malformations of the heart frequently associated with other systemic diseases called?
congenital heart disease
The AHA feels that most patients with congenital heart disease are not at risk for – from dental treatment bacteremia.
endocarditis
What severe lesions of the heart recommend a premed to prevent endocarditis?
valvular dysfunction, congestive heart failure, need for valve replacement, multiple embolic events.
what severe heart condition REQUIRES a premed?
unrepaired cyanotic lesions with palliative shunts and repaired lesions with a prosthetic devices for the first 6 months, and repaired lesions with defects.
What is the congenital heart defect created by a thickening of the connective tissue of the mitral valve?
mitral valve proplase
What is caused by a microbial infection of the heart valves or lining of the heart?
infective endocarditis
What is caused by a microbial infection of the endothelium of the arteries?
infective endarteritis
What occurs when the heart tissues fail to conduct normal impulses from the atrium to the ventricles of the heart?
arrhythmias
Poorly insulated, older pacemakers are subject to malfunction when exposed to –
ultrasonic scalers, pulp testers
Patients with prosthetic heart valves often take — which may have dental implications.
anticoagulants
Patients with – grafts should have a premed for first 6mo after repair
dacron
Patients with pros heart valves who require — for oral infection should take a premed
incision and drainage
What is the recommended BP?
less than 140/90
Uncontrolled hypertension may result in —
heart attack, heart failure, stoke or kidney failure
Patients with a BP reading of — should be referred immediately for medical eval.
180/110
Hypertensive medications can effect the patients – and –
gingiva and salivary flow
What dental modifications are needed with angina patients?
shorter appointments not after lunch.
No treatment for – after a stroke
6 months
Treat patients who had a heart attack with caution for – following attack
6 mo
Evaluate IRN prior to – for patients with heart attack, angina or stoke
extractions, perio therapy and surgery
A a patient with heart attack, angina or stroke is taking – or – , minimize use of local ane with vasoconstrictors
aldomet or fifitalis
Do heart attack, angina or stroke patients need a premed?
no
What potential emergency situation can arise in patients with heart attack, angina and stroke?
heart attack, cadiac arrest, CVA
Is a premed needed for a heart murmur?
no
What conditions of infective endocarditis indicate a premed?
history or IE
presence of p heart valve
Do patients with a pacemaker need a premed?
no
When is a premed needed in patients with p heart valves?
within 6 months following surgery or if leakage is present
If a patient is taking anticoagulants, test patients –
INR
When do you need a premed for open heart surgery?
6months or beyond, heart transplants
What condition of hypertension indicates a medical consult?
uncontrolled, undiagnosed high BP
What drugs are to be avoided in patients with high BP?
vasoconstrictors in large doses (3 or more cartridge’s)
What dental mods should be made for high BP patients?
shorter appointments, reduced stress and anxiety
