Ischaemic Heart Disease Flashcards
What is early atherosclerosis?
Circulation cholesterol-rich low-density lipoprotein (LDL) particles infiltrate the arterial wall
LDL is modified by oxidation and taken up by macrophages to form foam cells
Foam cells accumulate to form fatty streaks
What is advanced atherosclerosis?
Oxidised LDL alters the arterial wall’s physical and biochemical properties
Circulating white blood cells infiltrate the expanding lesion
In response to ongoing injury a fibrous cap forms
What is the immediate action taken for someone with acute coronary syndrome?
Aspirin
IV access
Urgent transfer to cardiac catheterisation laboratory- to have a coronary stent placed
What drug treatment is given to patients following coronary stenting?
Aspirin and one of either
Clopidogrel
Prasugrel
Ticagrelor
What general considerations must be taken when treating patient with a coronary stent?
Exercise caution when considering treatment within 3 months of an acute coronary syndrome
What is the QT interval?
Represents interval from the start of ventricular depolarisation (QRS) to the end of ventricular repolarisation (end T wave)
What does an increased HR do to the QT interval?
It shortens it
What is long QT syndrome?
It is a rare inherited condition that can cause abnormal heart rhythms
What are some things patients with long QT syndrome must avoid?
Avoid strenuous physical activity
Avoid medications known to prolong the QT interval
What can be used to treat long QT syndrome?
Beta blockers- propranolol
Implantable defibrillators
What are some dental implications of patients with long QT syndrome?
Avoid certain antibiotics- erythromycin, aztihromycin, clarithromycin
Avoid certain anti fungal- fluconazole, itraconazole, ketoconazole
Adrenaline is contraindicated
Bupivicaine LA can induce arrhythmias and is best avoided
Alleviate patient anxiety
Check electrolytes prior to GA
