Download Slide 1

yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts

Baker Heart and Diabetes Institute wikipedia, lookup

Cardiac contractility modulation wikipedia, lookup

Electrocardiography wikipedia, lookup

Heart failure wikipedia, lookup

Remote ischemic conditioning wikipedia, lookup

History of invasive and interventional cardiology wikipedia, lookup

Saturated fat and cardiovascular disease wikipedia, lookup

Drug-eluting stent wikipedia, lookup

Cardiovascular disease wikipedia, lookup

Quantium Medical Cardiac Output wikipedia, lookup

Cardiothoracic surgery wikipedia, lookup

Dextro-Transposition of the great arteries wikipedia, lookup

Management of acute coronary syndrome wikipedia, lookup

Coronary artery disease wikipedia, lookup

Antihypertensive drug wikipedia, lookup

Cardiovascular diseases
Dr Hazem Al-Ahmad
B.D.S, MSc(Lon), F.D.S.R.C.S
Cardiovascular disease
• Oral-maxillofacial surgery has minor direct
imapct on vital organ systems.
• Physiologic stresses produced by surgery and
anaesthetic techniques can lead to serious
morbidity and mortality
Ischaemic heart disease
• Insufficent blood supply to the myocardium
due to coronary artery obstruction and spasm
– myocardial ischaemia.
• Angina pectoris – stable/unstable
• Risk factors: family hx, male, increased
cholesterol, hypertension, smoking.
• Nitroglycerin – submucosal for angina only.
• ECG:
ST elevation
Can detect old infarct
• Chest x-ray: can detect congestive heart failure
• Condition needs to be controlled before surgery.
• Postpone surgery after MI for 6 months – risk of
Myocardial infarction
• Infarcted area become non-functional and
necrotic – dysrhythmias.
• May need a pacemaker
• Some pts receive aspirin or anticoagulants
• Anxiety-reduction protocol
• Prohpylactic GTN
Heart failure
• Right and left ventricular dysfunction
• Diseased myocardium can not meet the
demand – pulmonary edema, hepatic
• Orthopnea, paroxysmal nocturnal dyspnea
• High risk for major cardiac events
• Risk can be reduced with:
Diuretic therapy
Afterload reduction
Digoxin therapy
Anxiety-reduction program
Avoid excessive epinephrine
No supine position
Coronary artery bypass grafting
• Delay major surgery for 6 months after CABG,
• Routine MOS can be safely performed with
anxiety reduction protocols.
Coronary angioplasty
• Same for angina patients
Cardiovascular accidents
Patients on anticoagulants
Blood pressure lowering agents
Anxiety reduction protocols
Oxygen suuplements
• Decrease epinephrine
• Anticoagulants or pacemakers (avoid electric
• Essential hypertension
• Damage to vital organs: kidneys, brain, heart.
• Many treatment options: diuretics,ACE
inhibitors, angiotensin receptor blockers, Bblockers, calcium channels blockers and
• Delay elective surgery if uncontrolled.
• Low anxiety, low epinephrine.