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BMS10 > Intro to Cardiovascular Disease > Flashcards

Intro to Cardiovascular Disease Flashcards

1
Q

What is hypertension?

A

Persistently high blood pressure >140/90mmHg

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2
Q

What drugs are taken by patients with hypertension and what do they do?

A

Aspirin - anti-platelet drug

Captopril - ACE inhibitor

Atenolol - b1-blocker

Candesartan - angiotensin II receptor blocker

Nifedipine - calcium ion channel blocker

Bendroflumethiazide - diuretic

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3
Q

What are the possible primary causes of hypertension?

A

Genetic

Environmental - obesity, alcoholism, salt intake, stress

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4
Q

What are the possible secondary causes of hypertension?

A

Renal disease

Pregnancy

Endocrine disease

Drugs

Coarctation of aorta

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5
Q

How is hypertension diagnosed?

A

3 occasions over a 3 month period (consistently) at least

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6
Q

How are the primary causes of hypertension treated?

A

(General advice)

Weight loss

Increased exercise

Reduce alcohol intake

Stop smoking

Reduce salt intake

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7
Q

What are the complications of hypertension?

A

Heart failure

Stroke (cerebrovascular accident/CVA)

Coronary artery disease/myocardial infarction

Renal failure

Peripheral vascular disease

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8
Q

What is considered severe hypertension?

A

> 180/110mmHg

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9
Q

How is hypertension relevant in dentistry?

A

Minimise stress and pain to prevent further increase in blood pressure

No problem with adrenaline in local anaesthetic (as long as no intravascular injection)

Controlled hypertension = treat as normal

Uncontrolled hypertension = delay treatment and refer to a GP

Severe hypertension = refer urgently to hospital

More likely to have post-operative bleeding

Likely to be taking aspirin

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10
Q

What are the oral manifestations of drugs used to treat hypertension?

A

ACE inhibitors = loss of taste, angioedema, lichenoid reactions

b-blockers = lichenoid reactions

Calcium ion channel blockers = gingival overgrowth

Diuretics = xerostomia

K+ channel activators = oral ulceration

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11
Q

What is xerostomia?

A

Dry mouth

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12
Q

What does haemostasis require?

A

Vasoconstriction

Platelet plug

Coagulation

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13
Q

What additional measures can be taken to achieve haemostasis?

A

Extra pressure

Minimise trauma

Sutures

Haemostatic material in sockets

Post-operative instructions

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14
Q

What drug is used to treat hypercholesterolaemia?

A

Simvastatin

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15
Q

What are the risk factors of deep vein thrombosis?

A

Immobility

Surgery

Obesity

Pregnancy

OCP

Smoking

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16
Q

What is the international normalised ratio?

A

How long it takes for blood to form a clot (therefore determines effect of an oral anticoagulant)

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17
Q

What is the typical INR for DVT?

A

2-3

18
Q

What is syncope?

A

Fainting

19
Q

Why must you lay a fainted patient flat?

A

So blood can reach brain otherwise fitting will occur

20
Q

How can you avoid patient syncope?

A

Extra reassurance and time

Ensure patient has eaten before procedure (glucose drinks)

21
Q

What may cause syncope in a dental setting?

A

Stress, pain, fear

22
Q

What is/causes postural hypotension?

A

Posture change (sitting to standing) causes blood to pool in lower limbs

Sudden drop in blood pressure

23
Q

In which types of patient is postural hypotension common?

A

Elderly

Those taking antihypertensive medication

24
Q

How can you avoid postural hypotension in dentistry?

A

Sit patient up slowly from lying down

Verbal cues

25
Q

What is ischaemic heart disease?

A

Term given to heart problems caused by narrowed coronary arteries

26
Q

What is myocardial infarction?

A

Death of the muscle cells of a blocked coronary artery as insufficient oxygenated blood supply

27
Q

What is angina?

A

The crushing chest pain caused by insufficient oxygenated blood reaching the heart

28
Q

What is the aetiology of IHD?

A

Atheromatous plaque within coronary arteries constrict blood flow

29
Q

What can rupturing of the atheromatous plaque in IHD cause?

A

Acute thrombi

Myocardial infarction

30
Q

What are the modifiable risk factors for IHD?

A

Hyperlipidaemia, obesity, lack of exercise, diabetes

Smoking, high alcohol intake, OCP

Stress, hypertension

31
Q

How can angina be relieved?

A

Rest

Glyceryl trinitrate/GTN/nitroglycerin

32
Q

What is unstable angina?

A

Angina that increases rapidly in severity and occurs at rest

33
Q

What can provoke angina?

A

Exercise

Emotion

34
Q

What drugs can be used in the treatment of angina?

A

GTN/nitrates

b-blockers

Calcium ion channel blockers

K+ ion channel blockers

35
Q

How can angina be treated surgically?

A

Angioplasty (stent insertion)

Coronary artery bypass graft

36
Q

What are the symptoms of myocardial infarction?

A

Severe crushing chest pain >15mins

Shortness of breath

Nausea and vomiting

Paleness

Sweating

Tachycardia

37
Q

What is tachycardia?

A

Very high heart rate

38
Q

What is brachycardie?

A

Very low heart rate

39
Q

What is the relevance of IHD in dentistry?

A

Stress and pain may trigger angina or MI

May present as jaw pain

Patient may be using GTN and/or aspirin

Unstable angina = delay treatment until controlled

40
Q

What is an example of a K+ channel activator?

A

Nicorandil

BMS10 (13 decks)

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