cardiovasular patient in dentistry
TRANSCRIPT
-
7/30/2019 Cardiovasular Patient in Dentistry
1/16
Cardiovascular patient in Dentistry
Iyad Abou RabiiDDS. OMFS. MRes. PhD
-
7/30/2019 Cardiovasular Patient in Dentistry
2/16
WhoPatients with the following medical conditions may require either a modification in dental treatment plan:
High- and moderate-risk categories of endocarditis,
pathologic heart murmurs,
hypertension,
unstable angina pectoris,
recent myocardial infarction,
cardiac arrhythmias,
poorly managed congestive heart failure
-
7/30/2019 Cardiovasular Patient in Dentistry
3/16
Main signs & symptoms of C.V.S diseases
Chest pain
Dysnea
cyanosis
palpitation
Syncope
Edema of ankles
Cold pale extremities
Clubbing fingers
Easy fatigue
-
7/30/2019 Cardiovasular Patient in Dentistry
4/16
Angina pectoris
Myocardial infarction
Acute coronary insufficiency
Cardiac arrhythmia
Heart failure
Sudden death ( cardiac arrest, ventricular
fibrillation )
Asymptomatic ( silent )
presentation of heart diseases
-
7/30/2019 Cardiovasular Patient in Dentistry
5/16
ANGINA PECTORIS
It is a myocardial ischemia resulting from imbalance
between coronary blood flow & oxygen demand
Angina is pain that starts in the chest. Sometimes it
spreads to your lower jaw.
Some people with angina take drugs called calciumchannel blockers. That can cause gingival overgrowth.
-
7/30/2019 Cardiovasular Patient in Dentistry
6/16
1. People with stable angina can be treated like any
other patients, with a few differences. dentist should
have oxygen and nitroglycerin available during yourvisit and should consult with physician before the
appointment to evaluate condition.
2. People with unstable angina should not receive
elective dental care. Emergency dental care shouldbe performed under continuous heart monitoring.
DENTALMANAGEMENT OF ANGINA
-
7/30/2019 Cardiovasular Patient in Dentistry
7/16
MYOCARDIAL INFARCTION
It results from occlusion of coronary artery by a thrombusso deficient coronary arterial blood supply to a region ofmyocardium that results in a cellular death & necrosis.
Dental management:
As angina pectoris except;
Drugs used in treatment.
-
7/30/2019 Cardiovasular Patient in Dentistry
8/16
CONGESTIVE HEART FAILURE
It is the ability of heart to pump sufficient blood to meet themetabolic needs of the heart.
Dental management:
Same as angina except; 1.preoperative antibiotic.
2. Drugs used in treatment.
3. Dental management
-
7/30/2019 Cardiovasular Patient in Dentistry
9/16
CONGESTIVE HEART FAILURE
The medications for this condition can usually cause dry mouth
and gingivitis.
People with more severe heart failure should not lie down in the
dental chair too far because the fluid build-up in their lungs may
affect breathing.
They should also take it slow when moving from a standing
position to the chair, and when standing up from the chair,
because they can become dizzy and light-headed easily.
-
7/30/2019 Cardiovasular Patient in Dentistry
10/16
Stroke
If the patient have had a stroke in the past, then
as a dentist we should know if the patient
is taking anticoagulants (blood-thinning drugs).
So any procedure like extraction should be
carried out taking in to factor the bleeding and
clotting time . Usually the patient is asked to stopthe medication 5 days prior to the dental
appointment.
-
7/30/2019 Cardiovasular Patient in Dentistry
11/16
High Blood Pressure (Hypertension)
dry mouth or an altered
sense of taste (dysgeusia). Others may make you
more likely to faint when you are raised from the relatively flat
position in the dentists chair to a sitting or standing position
quickly. This reaction is called orthostatic hypotension.
Some anti hypertensive drugs like Calcium channel blockers are
known to have produced Gingival Hyperplasia.
-
7/30/2019 Cardiovasular Patient in Dentistry
12/16
High Blood Pressure (Hypertension)
The first time a patent visits the dental office after being
diagnosed with high blood pressure, dentist should take reading
of blood pressure two or three times.
This is to establish a baseline blood pressure. This way, the
dentist will know if the patients blood pressure changes in
response to treatment or a medicine.
-
7/30/2019 Cardiovasular Patient in Dentistry
13/16
SPECIAL GUIDELINES FOR DENTISTS
with CVS
(A) The patient should the treating dentist a complete list of the names and
dosages of all the drugs you are taking for your heart condition (as well as any
other prescription or nonprescription drugs that you may be taking). This will help
the dentist in deciding on the best course of treatment .
(B) Any of the procedure should be carried out only after a written permissionfrom a certified cardiologist. Without certified consultation no treatment should be
tried.
(C) The dentist should record the address and contact of the treating cardiologist
of the patient in case there might be some need to talk to him/her.
(D) Any major surgical should only be carried out in the presence of a certifiedcardiologist.
-
7/30/2019 Cardiovasular Patient in Dentistry
14/16
Prophylactic antibiotics
Cardiac Valves,
Previous Bacterial Endocarditis,
Complex Cyanotic Congenital Heart Disease,
Surgically Constructed Systemic Pulmonary Shunts or Conduits)
Moderate-Risk Patients (i.e., Rheumatic, Congenital, or Other
Acquired Valvular Heart Disease, Hypertrophic Cardiomyopathy,
and Mitral Valve Prolapse with Regurgitation and/or ThickenedLeaflets) Who are Undergoing Invasive Dental Procedures
-
7/30/2019 Cardiovasular Patient in Dentistry
15/16
Thank you foryour attention!
Any Questions?
-
7/30/2019 Cardiovasular Patient in Dentistry
16/16
Feel free to use this PowerPoint presentation for your personal,educational and business.
Do
Make a copy for backups on your harddrive or local network.Use the presentation for your presentations and projects.
Print hand outs or other promotional items.
Dont
Make it available on a website, portal or social network website for download.(Incl. groups, file sharing networks, Slideshare etc.)Edit or modify the downloaded presentation and claim / pass off as your own work.
All copyright and intellectual property rights, without limitation, are retained by Dr. Iyad Abou Rabii. Bydownloading and using this presentation, you agree to this statement.
Please feel free to contact me, if you do have any questions about usage.Dr Iyad Abou [email protected]
Copyright notice