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SU18: Internal med final > Heart Surgery & Devices > Flashcards

Heart Surgery & Devices Flashcards

1
Q

what are some common cardiac surgery and devices?

A
  • stents
  • CABG
  • pacers
  • defibrillators
  • valves
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2
Q

re-stenosis rate and return of syms of pts who had balloon angioplasty?

A

w/in 6 mos for 10-50% of pts

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3
Q

re-stenosis rate of pts who had balloon angioplasty with placement of stent?

A

reduced re-stenosis to 20-30%

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4
Q

types of coronary artery stents

A
  1. bare metal
  2. drug-eluting
  3. bioresorbable
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5
Q

drug-eluting stent

A

metal stent coated with a polymer containing anti-proliferative agents that inhibit re-stenosis

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6
Q

which type of stent has an increased risk of thrombosis for 1 year after placement?

A

drug-eluting stent

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7
Q

should pts w stents placed be given antibiotic prophylaxis?

A

no but check with cardiologist if recently placed (<1 month)

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8
Q

pts with stents placed are taking what type of drugs?

A
  • Aspirin and clopidogrel

- dual antiplatelet therapy

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9
Q

should pts with stents discontinue taking their aintiplatelet drugs before their dental appt?

A

no

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10
Q

how long should you wait before treating pt post-stent placement?

A

at least a month

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11
Q

what is the underlying disease process for CABG?

A

coronary artery disease

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12
Q

do pts with CABG need antibiotic prophylaxis?

A

no

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13
Q

pts with CABG are on what type of drugs?

A
  • dual antiplatelet therapy (DAPT)

- aspirin and clopidogrel

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14
Q

should pts with CABG discontinue their medications before their dental appointment?

A

NO

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15
Q

implantable pacemaker is for what heart condition?

A

bradycardia

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16
Q

how does an implantable pacemaker work?

A

if SA node not functioning properly (ie not sending out beat at regular pace) so pacemaker will fill in when SA node falls behind

17
Q

implantable cardioverter-defibrillator (ICD) is for what heart condition?

A

ventricular tachycardia

18
Q

electromagnetic interference of pacemaker or ICD

A
  • detects extraneous signal and misinterprets them

- can cause rate alterations, sensing abnormalities, asynchronous pacing, reprogramming

19
Q

do pts with implanted cardiac devices need antibiotic prophylaxis?

A

no

20
Q

cause of valvular disease

A
  • scarring of myocardial tissues (MI)
  • overwork of leaflets (HTN)
  • calcium deposits causing thickening of leaflets (age)
  • infections (IE)
21
Q

which valves are most commonly involved in valvular disease?

A

aortic and mitral valves

22
Q

prolapse valve

A

blood coming from atrium to ventricle is getting shoved back into atrium

23
Q

do aortic valves get prolapsed?

A

no, they’re not designed like mitral valves

24
Q

stenosis of valve

A
  • opening narrowed so blood doesn’t exit heart as it should

- leads to heart failure

25
Q

regurgitation of valves

A

blood squirting back into atrium

26
Q

progression of valvular disease

A
  • blood backs up into pulmonary vasculature
  • blood backs up in systemic vasculature
  • heart failure
27
Q

diagnosis of valvular disease

A
  • signs/symptoms of heart failure
  • cardiac auscultation for murmurs
  • detection of murmur will prompt further investigation
28
Q

echocardiogram

A
  • used for definitive diagnosis of valvular disease
  • ultrasound of heart showing size & shape of heart, anatomic abnormalities
  • how well chambers and valves are working
29
Q

treatment of valvular heart disease

A
  • goal=optimize system to keep disease from progressing
  • close physician follow-up to catch before it progresses to pulmonary hypertension and heart failure
  • valve replacement
30
Q

mechanical replacement valves

A
  • made of strong, durable materials and last longer than other types of replacement valves
  • most will last throughout pt’s entire lifetime
31
Q

how long do pts with mechanical replacement valves have to take anticoagulant drugs for?

A

lifetime

32
Q

how long do pts with mechanical replacement valves have to take antibiotic prophylaxis drugs for?

A

lifetime

33
Q

bioprosthetic replacement valves

A

made from animal valves or other animal tissues that’s strong and flexible
- may last 10-20 years

34
Q

how long do pts with bioprosthetic replacement valves have to take anticoagulant drugs for?

A

temporarily (~3 months usually until suture lines are healed)

35
Q

how long do pts with bioprosthetic replacement valves have to take antibiotic prophylaxis drugs for?

A

lifetime

36
Q

normal INR

A

0.8-1

37
Q

INR goal for pts with valvular heart disease

A

2-3

38
Q

severe valvular disease is considered what type of risk?

A

major

SU18: Internal med final (25 decks)

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