Podcast
Questions and Answers
What is a possible risk for hypertensive patients in a dental setting?
What is a possible risk for hypertensive patients in a dental setting?
Which of the following is a type of Ischemic Heart Disease?
Which of the following is a type of Ischemic Heart Disease?
What is a crucial step in the dental management of patients with Ischemic Heart Disease?
What is a crucial step in the dental management of patients with Ischemic Heart Disease?
Which of the following is a cardiovascular disease risk factor?
Which of the following is a cardiovascular disease risk factor?
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What is Myocardial Infarction?
What is Myocardial Infarction?
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What is a possible oral health complication in patients with hypertension?
What is a possible oral health complication in patients with hypertension?
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Why is it essential to evaluate the patient's blood pressure before dental treatment?
Why is it essential to evaluate the patient's blood pressure before dental treatment?
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What is a consideration in the dental management of patients with cardiovascular disease?
What is a consideration in the dental management of patients with cardiovascular disease?
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What is the management of a cardiac patient who requires complex surgery or needs a general anaesthetic and is unstable with dyspnoea on minimal exertion?
What is the management of a cardiac patient who requires complex surgery or needs a general anaesthetic and is unstable with dyspnoea on minimal exertion?
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A patient with a recent myocardial infarction (< 6 months post MI) requires a Type III dental procedure. What is the recommended management?
A patient with a recent myocardial infarction (< 6 months post MI) requires a Type III dental procedure. What is the recommended management?
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Which of the following is a characteristic of severe angina?
Which of the following is a characteristic of severe angina?
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What is the management of a patient who has had a myocardial infarction (> 1 year post MI) and requires a Type V dental procedure?
What is the management of a patient who has had a myocardial infarction (> 1 year post MI) and requires a Type V dental procedure?
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What is the primary factor in determining the dental management of a patient with ischemic heart disease?
What is the primary factor in determining the dental management of a patient with ischemic heart disease?
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A patient with a history of myocardial infarction (> 1 year post MI) and stable angina requires a Type II dental procedure. What is the recommended management?
A patient with a history of myocardial infarction (> 1 year post MI) and stable angina requires a Type II dental procedure. What is the recommended management?
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What is the primary goal in managing a patient with ischemic heart disease in a dental practice?
What is the primary goal in managing a patient with ischemic heart disease in a dental practice?
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What is the classification of a dental procedure that involves a simple extraction, curettage, and gingivoplasty?
What is the classification of a dental procedure that involves a simple extraction, curettage, and gingivoplasty?
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What is the primary cause of Ischaemic Heart Disease (IHD)?
What is the primary cause of Ischaemic Heart Disease (IHD)?
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What is the typical duration of an anginal attack in a dental clinic?
What is the typical duration of an anginal attack in a dental clinic?
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What is the primary goal of managing a patient with a history of CVD and chest pain in a dental clinic?
What is the primary goal of managing a patient with a history of CVD and chest pain in a dental clinic?
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What is the recommended dose of glyceryl trinitrate (GTN) for a patient with chest pain in a dental clinic?
What is the recommended dose of glyceryl trinitrate (GTN) for a patient with chest pain in a dental clinic?
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What is a sign that is suggestive of Myocardial Infarction (MI)?
What is a sign that is suggestive of Myocardial Infarction (MI)?
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What is the recommended oxygen flow rate for a patient with chest pain in a dental clinic?
What is the recommended oxygen flow rate for a patient with chest pain in a dental clinic?
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What is a common risk factor for Ischaemic Heart Disease (IHD)?
What is a common risk factor for Ischaemic Heart Disease (IHD)?
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What is the recommended course of action if chest pain persists for 10 minutes in a dental clinic?
What is the recommended course of action if chest pain persists for 10 minutes in a dental clinic?
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Study Notes
Cardiovascular Diseases
- Vascular diseases: Aneurism, Vasculitis, Atherosclerosis
- Heart diseases: Carditis, Cardiomyopathy, Heart Failure, Valvar heart disease, Arrhythmia
- Ischemic heart diseases: Angina Pectoris, Myocardial Infarction
- Other cardiovascular diseases: Hypertension, Infective Endocarditis
Hypertension
- Possible risks for hypertensive patients:
- Oral health events (mainly due to drugs)
- Hypertensive attacks
- Management of hypertensive patients:
- Pre-treatment evaluation of blood pressure
- Proper history to evaluate patient risk
- Evaluate procedure risk
- Timing of appointment
- Control pain and anxiety
- Consider pre-treatment consultation
Dental Management of Patients with Cardiovascular Diseases
- Patient evaluation:
- Consult physician if patient indicates persistently high blood pressure
- Possible complications:
- Xerostomia
- Lichenoid drug reaction
- Gingival enlargement
- Oral ulceration
- Paraesthesia and disturbance in sensation
- Orthostatic hypotension
- Salivary gland swelling
- Addressing complaints:
- Evaluate patient and procedure
- Control stress, attack, and bleeding
- Categories of dental procedures:
- Type I: Examination, radiograph, impressions
- Type II: Simple operative procedure, prophylaxis, supra-gingival scaling, orthodontics
- Type III: Advanced operative procedure, scaling & root planning, endodontics
- Type IV: Simple extraction, curettage, gingivoplasty
- Type V: Multiple extractions, single impaction, flap surgery, single implant
- Type VI: Full arch/mouth extractions, major surgery
Angina and Myocardial Infarction (MI)
- Classification of angina:
- Mild angina: Frequency up to 1/month, stable, onset following severe exertion or emotion
- Moderate angina: Frequency up to 1/week, stable, onset following moderate exertion or emotion
- Severe angina: Daily episodes, unstable, onset following mild exertion, emotion, or at rest
- Dental management of MI patients:
- Time since last attack:
- < 6 months: defer, consultation, and sedation
- 6 months-1 year: defer, hospitalization
- > 1 year: normal protocol, sedation
- Time since last attack:
- Risk management:
- Hypertensive attack: discontinue treatment, place patient in supine position, allow rest, and re-check BP
Ischemic Heart Disease (IHD)
- Definition: Progressive myocardial ischaemia due to persistently reduced coronary blood flow
- Signs and symptoms:
- Chest pain (retro-sternal, radiating to left shoulder & arm, back, neck, and jaw)
- Heavy, squeezing, crushing character
- Precipitating factors: exertion, emotion, cold, heavy meal
- Relieving factors: rest, sublingual nitrates (coronary vasodilator)
- Duration: few minutes
- Management of patient with hx of CVD and chest pain:
- Stop dental treatment
- Place patient upright
- Give glyceryl trinitrate (GTN) 0.5mg sublingually
- Give oxygen 5L/min, monitor vital signs
- If pain persists, consider MI and summon medical help
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Description
This quiz covers the dental management of patients with cardiovascular diseases, including ischemic heart diseases, hypertension, heart failure, and more. It helps dental professionals understand the oral health implications of cardiovascular diseases.
