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Human Diseases > Dental significance of cardiovascular disease > Flashcards

Dental significance of cardiovascular disease Flashcards

1
Q

What is hypertenison?

A

Increased BP

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2
Q

What level of BP is hypertension?

A

140/90

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3
Q

What is also considered when diagnosing hypertension?

A

Overall cardiovascular risk (smoking, drinking, weight)

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4
Q

Describe aetiology of hypertension?

A

Poly-causal –> essentially a diagnosis of exclusion (looked at everything else that could be causing it cant find anything)

Environmental - obesity, salt intake, lack of exercise

Genetic

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5
Q

What is the most common cause of secondary hypertenison?

A

Renal artery stenosis

or
Endocrine causes line Conn’s or Cushing’s syndrome

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6
Q

Cushing’s syndrome vs Cushing’s disease?

A

disease = primary pituitary problem = excess circulating steroid
Disease is a type of syndrome

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7
Q

Effect of elevated BP?

A

Increase risk of coronary heart disease
Aortic aneurysm
Peripheral vascular disease
Cerebral circulation

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8
Q

therapeutic measures of hypertension?

A

weight reduction
Exercise
Decrease salt intake
Alcohol reduction

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9
Q

therapeutic measures that will reduce risk of cardiovascular disease but not BP?

A

Stop smoking
Reduce saturated fat
Increase intake of oily fish

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10
Q

What is a major risk factor if CVS disease that relates to dentistry?

A

Periodontal disease

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11
Q

Sources of blood-borne infections that could cause infective endocarditis?

A

Mouth = toothbrushing, chewing, gingival bleeding
Skin
GI tract
Pregnancy (delivery)

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12
Q

Is antibiotic prophylaxis routinely given against infective endocarditis?

A

NO

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13
Q

Complications of antihypertensive treatment

A

Orthostatic hypertension - light headed as they lie flat
Xerostomia
Gingival overgrowth
Drug interactions

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14
Q

Main drug that is often given to patients with CVS disease that has lots of drug interaction?

A

Warfarin

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15
Q

Considerations relevant of dental management of patients with significant CVS compromise?

A

Shorter appointments, in the morning
Effective LA
Conscious sedation - reduce stress
post-op analgesia

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16
Q

Why is there queries about giving CVS patients LA?

A

LA is a vasoconstrictor

17
Q

How does endogenous adrenaline react when under stress?

A

Increase x20

18
Q

How does the adrenaline in LA differ to endogenous?

A

May not be as effective, definitely not straight away

19
Q

What are the recommendations for LA use in patients with CVS disease?

A

Patients with mild to moderate CVS disease can have LA containing adrenaline as usual.
Patients with severe CVS disease may be considered relative contraindication to VC use

20
Q

What constitutes severe CVS disease?

A

Unstable angina, recent MI, severe high BP

21
Q

Patients with ischaemic heart disease, specific considerations regarding dental treatment:
a) how long should elective treatment be postponed after acute MI?
b) how should you go about treating patient with unstable angina (e.g. angina at rest)
c)

A

a) 6 months

b) should not be treated in primary care

22
Q

What do you need to ensure is compatible in patients with pacemakers or implanted defibrillators?

A

Diathermy
Electrosurgical units
Ultrasonic scalers
Anything electronic

23
Q

How should dental treatment differ on a patient with cardiac surgery?

a) Effects of stent/angioplasty/valve replacement
b) immediate post-op period

A

a) procedures do not pose contraindications

b) avoid treatment as immature suture line susceptible to bacterial infection

24
Q

Why are patients with unstable CVS disease better treated in secondary care?

A

They need to be carefully monitored suing equipment like BP, ECG

25
Q

What should you do if a patient has angina attack?

A

GTN spray, 2 actuations every 3 mins
Should feel better after 2 sprays, if you have to repeat start thinking, could this be MI

100% oxygen at 15 litres/minute

26
Q

If you think a patient may be having an MI, why give them aspirin to chew?

A

Anti-platelet effect

27
Q

How should you manage patients taking anti-platelet drugs like aspirin?

A

No alteration to drug regime for treatment but do make sure haemostasis have been achieved (cellulose mesh)

28
Q

How should you manage patents taking warfarin?

A

INR check on the day of the invasive procedure
If INR value above 4, warfarin should be altered.
If below 4 - no alteration just ensure haemostasis

29
Q

Oral manifestations related to cardiovascualr disease and cause?

A 
dry mouth
gingival hyperplasia
angiodemia
lichenoid drug reactions 
due to the drugs they are taking
30
Q

What drugs cause xerostomia?

A

Beta blockers
Diuretics
ACE inhibitors
Ca channel blockers

31
Q

What drugs cause lichenoid drug reactions?

A

NSAIDs
Beta blockers
Diuretics
Statins

32
Q

What drugs cause angiodema?

A

ACE inhibitors

33
Q

Common adverse effects of calcium channel blockers?

A

Gingival overgrowth

Human Diseases (37 decks)

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