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Questions and Answers
What type of angina is characterized by chest pain that occurs spontaneously, often at rest, and is more common in women under 50 years old?
Which symptom is commonly associated with an acute myocardial infarction (AMI)?
What is the recommended first step in treating a patient experiencing angina during a dental procedure?
Which of the following is a recognized risk factor for the development of myocardial infarction?
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How is stable angina typically induced?
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What action should be taken if a patient experiencing angina does not find relief after the second dose of nitroglycerin?
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Which statement best describes unstable angina?
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In diagnosing angina pectoris, which method is commonly used to assess heart function under stress?
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What is the primary role of administering oxygen to a patient experiencing angina?
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What is the most common cause of chest pain originating from cardiac issues?
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Which symptom is most commonly associated with an Acute Myocardial Infarction (AMI)?
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Which of the following treatments is most effective for managing angina symptoms?
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Which risk factor is linked to an increased incidence of Coronary Artery Disease as individuals age?
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What diagnostic test is commonly used to confirm the presence of Coronary Artery Disease?
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What lifestyle modification is considered the single most effective way to reduce heart disease risk?
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Which gender typically develops coronary artery disease risk factors later in life?
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Which of the following is the leading preventable cause of death related to cardiovascular issues?
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Study Notes
Coronary Heart Disease (CHD) and Coronary Artery Disease (CAD)
- Secondhand exposure increases the likelihood of developing CHD/CAD by 20-30%.
- Hypertension has a direct correlation with CHD; approximately 46% of U.S. adults have high blood pressure (HBP).
- Hypercholesterolemia signifies high blood cholesterol, which is essential for diagnosing cardiovascular conditions, as excess cholesterol leads to atherosclerosis and CHD/CAD.
- Diabetes complicates CHD/CAD, as atherosclerosis is more severe in diabetics, with 75% of diabetics succumbing to some form of cardiovascular disease (CVD).
- Obesity is a significant risk factor for CHD/CAD and can lead to Type 2 Diabetes. Weight management, diet, and exercise are critical in reducing hypertension and hypercholesterolemia.
Angina Pectoris
- A condition characterized by inadequate oxygen supply to the heart, often due to atherosclerosis.
- Symptoms indicate CHD/CAD and are common emergencies, especially in dental settings.
- As plaque builds up, arterial openings decrease, leading to potential heart tissue infarction.
Forms of Angina
- Stable Angina: Induced by physical activity or stress, worsens in cold weather or post-meal. Responds to nitroglycerin.
- Variant Angina (Prinzmetal's): Caused by coronary artery spasms, occurring at rest. More common in women under 50. Nitroglycerin often provides relief.
- Unstable Angina: A progression of atherosclerosis with symptoms that may not respond to nitroglycerin. Considered a prelude to myocardial infarction (MI).
Signs and Symptoms of Angina
- Generalized chest discomfort, described as dull, burning, or squeezing.
- Discomfort can radiate to the left shoulder, arm, neck, jaw, or tongue.
- Additional symptoms include diaphoresis, pallor, nausea, increased pulse, and BP, lasting between 1-15 minutes.
Treatment of Angina
- Immediate action includes terminating treatment and placing the patient in a semi-supine or upright position.
- Administer oxygen (4-6 L/min via nasal cannula), monitor vital signs, and use sublingual nitroglycerin.
- Nitroglycerin dilates coronary vessels, alleviating symptoms usually within 2-4 minutes.
- Observe for potential side effects like flushing or hypotension and resume treatment post-recovery.
Myocardial Infarction (MI)
- Acute MI results from myocardial necrosis due to total or partial coronary artery occlusion via atherosclerosis, thrombus, or spasm, potentially leading to cardiac arrest.
- Classic MI symptoms include severe chest pain lasting 20+ minutes, accompanied by dizziness, dyspnea, cool moist skin, and a sense of impending doom.
Treatment of Myocardial Infarction
- Terminate any ongoing procedure and position the patient comfortably.
- Contact emergency medical services (EMS) based on the patient's angina history.
- Administer oxygen (4-6 L/min) and nitroglycerin as needed; if pain persists, consider MI diagnosis.
- Administer chewable aspirin (325 mg) for its antithrombotic effect, manage pain with nitrous oxide if available.
Risk Factors for Coronary Artery Disease (CAD)
- Gender: Equivalent risk for males and females, though risk in women rises later in life.
- Age: Increased risk correlates with age, doubling every decade.
- Heredity: Family history increases the likelihood of CHD/CAD; absence may improve survival rates.
- Smoking: A leading global risk factor for mortality, with secondhand smoke being significant; it's preventable death's primary cause in the U.S.
- Obesity, high blood pressure, and high cholesterol are additional risk factors.
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