W2: Managing CV Pts

Question 1

HBP + Hypertension
What are the manifestations of antihypertensives?

What level of BP is too high??

Answer 1

Lichenoid drug eruption, also called drug-induced lichen planus, is an uncommon, cutaneous adverse effect of several drugs [1-4]. It is characterized by a symmetric eruption of flat-topped, erythematous or violaceous papules resembling lichen planus on the trunk and extremities

Question 2

Arrythmia + Congenital HD
- give examples of anticoagulants and list some of their side effects.

Answer 2

Question 3

RDH & IE

Answer 3

Question 4

MI

Answer 4

Question 5

Discuss cardiovascular disease in terms of risk, modifiable and non-
modifiable risk factors

Answer 5

Question 6

Discuss modifications to periodontal treatment associated with
cardiovascular diseases and associated medications

Answer 6

Question 7

Discuss cardiovascular disease and link to periodontal disease

Answer 7

The bacteria that infect the gums and cause gingivitis and periodontitis also travel to blood vessels elsewhere in the body where they cause blood vessel inflammation and damage; this increases the risk of tiny** blood clots (CAD), atherothrombosis, heart attack and strok**e may follow.
A reduction in perio-pathogens is linked with lowered CRP inflammatory mediators, lowered fibrinogen levels, which prevents the risks of CVD issues.

Question 8

a) What are 3 common symptoms of HBP and 2 less common ones?

b) what are 3 management strategies for HBP?

Answer 8

Question 9

A common symptom of IHD is angina pectoris (pressure/ tightness in chest region) which can radiate to the left/right arm and even mandible.

a) Patients may also ___________
b) management?

Answer 9

Patients may also feel faint, sweating, SOB and anxiousness. Dental management involves giving the patient nitroglycerin sublingually (note has oral SE:xerostomia), and apps should ideally be short during the early mornings with stress reduction techniques.

Question 10

Patients with cardiac defects (impaired blood flow due to holes in chambers of the heart) have a weakened heart

a)..and so will experience what 6 symptoms?

b) 2 dental considerations?

Answer 10

1. fatigue
2. SOB
3. poor growth/development,
4. chest deformity
5. presentation of cyanosis
6. heart problems (congestive heart failure and heart murmurs)

2 considerations
1. increased risk of developing RHD (this is due to inflammation of heart valves, thus prevention of strep throat is critical)

2. antiarrhythmic medication oral SE (low/high saliva, taste impairment).

Question 11

what are 3 common manifestations of children with cardiac defects?

Answer 11

Question 12

For children with heart defects…
a)Who has an increased risk of IE?

b)When is AB prophylaxis required?

c) when is AB not required?

Answer 12

a)
1. previous IE
2. Prosthetic valve
3. CHD with unrepaired defects
4. RHD
5. heart transplant

b) perforating oral mucosa for tx such as: extraction, subgingival scaling, root planing, replanting avulsed teeth, other: implant, biopsy, removal of soft tissue or bone)

c) do NOT need Ab:

1. Mitral valve prolapse
2. Septal defects
3. Cardiac implantable electronic devices

Question 13

what is RHD?

Answer 13

A disease that can result from inadequately treated strep throat or scarlet fever.
Rheumatic fever causes inflammation, especially of the heart, blood vessels and joints.
Symptoms include fever and painful, tender joints.
Treatment involves medication, sometimes for life.

Question 14

Your patient has a weakened heart valve

a) they are at risk of what?

b) what must you give to manage this?

Answer 14

a) risk of transient bacteremia during dental cleanings when bleeding occurs. Antibiotic prophylaxis is therefore required to prevent IE for patients with really bad cardiac complications (prosthetic heart valves, history of IE or rheumatic fever, IV drug use, existing cardiac abnormalities).

b) ABP: A2C6

Question 15

Your patient asks you how their heart disease is linked to their oral health. Explain.

Answer 15

well Mrs. patient
1. The perio bacteria that infect the gums and cause gingivitis and periodontitis also travel to blood vessels elsewhere in the body where they cause blood vessel inflammation and damage;

2. this increases the risk of tiny blood clots (CAD), atherothrombosis, heart attack and stroke may follow.
3. A reduction in perio-pathogens is linked with lowered CRP inflammatory mediators, lowered fibrinogen levels, which prevents the risks of CVD issues.

Question 17

You have patient A, B, C each taking a particular medication for their heart condition.

Discuss what dental symptoms may occur due to taking these meds:
a) anti-hypertensives
b) anti-coagulants
c) anti- arrhythmic

Answer 17

a) hyperplasia
b) bleeding
c) taste/saliva