Medical Conditions Flashcards
🔸Inability of myocardium to pump enough blood
🔸Lungs/and or circulatory system become congested
Congestive heart failure
Stress in congestive heart failure should be avoided due to
🔸Increase workload of heart surpassing functional ability
🔸Pulmonary Oedema
Congestive heart failure symptoms
🔸Extreme dyspnoea
🔸Hyperventilation
🔸Cough
🔸Hemoptysis(pinkish foam expectoration)
🔸Difficulty breathing
Preferred patient position in congestive heart failure
Sitting position
Management of congestive heart failure
🔸Consultation with cardiologist
🔸 Oral premedication, e.g., 5–10 mg diazepam (Valium) or 1.5–3 mg bromazepam (Lexotanil), 1 h be-
fore procedure
🔸Small amount of vasoconstrictor
🔸Short appointments as painless as possible
Temporary ischemia in Myocardium, resulting in diminished oxygen
Angina Pectoris
Symptoms of angina
🔸 Brief paroxysmal pain posterior to the sternum
🔸 Burning sensation, pressure, or tightness
🔸 Pain radiating to the left shoulder, neck, left arm (with a numb sensation as well as tingling), sometimes down the chin and teeth of the mandible (usually the left side)
🔸Pain sometimes felt in epigastrium, causing confusion in diagnosis
🔸Perspiration
🔸Extreme anxiety
These patients have an increased risk of angina pectoris symptoms in dental surgery
Coronary heart disease history
Episode of angina pectoris precipitated by
🔸Fatugue
🔸Stress
🔸Rich meal
Symptoms of Angina Pectoris subside after
🔸2-5 minutes of rest
🔸Administering of vasodilator
Treatment of Angina pectoris
🔸Consultation with cardiologist
🔸 5–10 mg diazepam (Valium) or 1.5–3 mg bromazepam (Lexotanil) orally, 1 h before the surgical procedure
🔸Carrying out procedure in hospital
🔸Small amounts of vasoconstrictor in LA
🔸Short appointments
Ischemic necrosis of an area of the heart due to complete blocking of branches of the coronary arteries
Myocardial infarction
Myocardial infarction symptoms
🔸 Sudden onset with severe pain posterior to the sternum, which increases in severity rapidly
🔸 w/ burning sensation, pressure, and extreme tightness
🔸 More severe compared to angina pectoris, lasts longer than 15 min and does not subside with rest or use of nitrates sublingually
🔸 Radiates to the left shoulder, neck region, mandible, teeth, midback region, epigastrium, and right arm
🔸 Nausea, vomiting, perspiration, and dyspnea
Management of myocardial infarction
🔸 Avoid routine dental surgery on patients with recent infarctions (within the last 6 months)
🔸 if treatment necessary (acute infection, pain, etc.), management should take place in a hospital
🔸Six months following the myocardial infarction, patients may also be treated in the dental office- follow same precautions as Angina pectoris
Damage of the mitral and aortic valves, which may be described as stenosis, or insufficiency
Rheumatic heart disease
May develop after invasive surgical procedures and is dangerous for patients with rheumatic fever
Transient bacteraemia
Management of Rheumatic heart disease
🔸Antibiotic treatment prior to surgery
🔸Avoidance of vasoconstrictors/ maximum concentration of 1:100,000
Importance of antibiotics in Rheumatic heart disease
Transient bacteraemia after surgical procedures can affect endocardium resulting in endocarditis
Pathologic sounds due to vibrations caused by turbulence in the circulation through the vessels or chambers of the heart
Murmurs
Heart murmurs are caused by
🔸Valve defects, resulting from rheumatic disease
🔸Septic endocarditis
🔸Syphilis
🔸Congenital heart conditions
Types of murmurs
🔸Systolic
🔸Diastolic
🔸Continuous
🔸Innocent/functional- good prognosis
Management of Murmurs
🔸Establish whether murmur is functional or pathologic
🔸Antibiotic prophylaxis
Types of congenital heart disease
🔸Patent ductus arteriosus
🔸Atrial septal defects
🔸Ventricular septal defects
🔸Idiopathic pulmonary stenosis
🔸Stenosis of pulmonary or aortic valve
Management of main congenital heart diseases
🔸Consultation with physician
🔸Premedication before treatment
🔸Antibiotic prophylaxis especially in Rheumatic heart Disease
🔸Limited vasoconstrictor use
🔸Short appointments