Jude20111.files.wordpress.com

?another cardiac condition that we might encounter in our profession is coronary artery bypass, its not a usual procedure to do , usually MI patients do catheterization (???????) as initial intervention , they do different x rays and heart echoes before doing It to try to locate the size and the site of the defective part of the artery.-if the artery has moderate function, they try to inject a balloon into the artery to reopen it(angioplasty) then they put a stent ( ??????? ) to try to stabilize it "sometimes they can put a balloon without the stent" - but if its function is deficient they try catheterization-finally if the artery is totally obstructed they tend to do coronary bypass as a last resort. how does that effect us as dentists ? what do we care for ? Routine dental procedures can be done usually safely, and these patient don’t need prophylactic antibiotics against infective endocarditis cuz there is no foreign or prosthetic devices were introduced to the body. So it not recommended to treat them with antibiotics but its important to know what medications they are taking as these patients often take warfarin or any other anticoagulant. * coronary Angioplasty:"form Wikipedia "angioplasty: is an endovascular procedure to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis. An empty, collapsed balloon, known as a balloon catheter, is passed over a wire into the narrowed locations and then inflated to a fixed size. The balloon forces expansion of the stenosis (narrowing) within the vessel and the surrounding muscular wall, opening up the blood vessel for improved flow, and the balloon is then deflated and withdrawn. A stent may or may not be inserted at the time of ballooning to ensure the vessel remains open.-Tx and management is the same as angina patients .*cardiovascular accidents:-patients with cardiovascular accidents usually take 1-anticoagulants 2-medications to lower BP 3- medications to lower anxiety 4- and oxygen supplements Ofcource these patients should be treated cautiously.*patients with dysrhythmia :we don't use epinephrine at all with these patients also we have to notice the presence of any pacemakers as its contraindicated to use any electric or magnetic devices with patients wearing pacemakers ,cuz they interrupt the function of it. Also we have to keep in mind that these patients also take anticoagulants. Now the vascular system: As we all know the most common vascular diseases is hypertension. hypertension is a chronic medical condition in which the blood pressure in the arteries is elevated.and its of 2 types:1-primary (essential) --> of unknown etiology 2-secondary --> due to other organ dysfunction eg: renal failure or endocrine disorders -we cant say that a patient is hypertensive from only one high reading, eg: if we took patients BP while he's in our clinic, its definitely gonna be a little bit more elevated cuz normally patients tend to get anxious and afraid when they visit doctors and that causes false elevation of BP, also the white coat syndrome that makes the patient uncomfortable while seated in ur clinic. So what we do is we give the patient a schedule that takes it home which allows him to monitor his BP at home while resting, this chart tells him when and how frequent he should check his BP, then he write down the reading and at the end we draw the reading on a chart. if we noticed that the chart in getting higher with presence of signs 100--> 150 --> 160 then we can say that he is hypertensive.Hypertension can be fatal (the silent killer) as it causes organ failure: kidneys , brain , heart.There are sooo many Tx options for hypertension like : 1-diuretics 2-ACEI 3- angiotensin receptor blockers 4- C+ channel blockers.The most important thing Is to know the type of the drug and to know that the condition is controlled or not. (if its uncontrolled we have to delay any dental treatment until BP is normal)its not preferable to use anesthetics with epinephrine try as much as possible to lower the anxiety and cool the atmosphere. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download