Cardiac

Matthews, A (2017). Managing Patients with Critical Cardiac Conditions. The Journal of Professional Excellence Dimensions of Dental Hygiene. 15(10).

This article is focusing on patients with some form of cardiovascular disease. In the first paragraph the article states that cardiovascular disease includes a broad group of diseases and conditions including; coronary artery disease, cerebrovascular disease, stroke, heart failure, high blood pressure, disorders of the heart rhythm, peripheral artery disease, venous thromboembolism, valvular disorders and congenital heart defects. Thankfully the mortality associated with cardiovascular disease is declining. Patients no have better outcomes due to awareness of signs and symptoms, risk and prevention, as well as advances in medical technology and research. The article states that many patients with cardiovascular disease manage their condition with DAPT (Dual Antiplatelet Therapy) and TATT (Triple Antithrombotic Therapy). This may mean that a patient is taking multiple medications. It is important for dental professionals to stay up to speed with the continuously updated cardiovascular disease treatment guidelines to ensure safe treatment. The article goes into detail about two common cardiovascular diseases, Acute Coronary Syndrome and Atrial Fibrillation. The article also discusses common treatments including percutaneous coronary intervention, (PCI), where a balloon is inserted into a plaque blocked artery and expanded in order to widen the area in which the blood has to flow. This procedure has developed into stents. Stents showed to have better outcomes, but still have significant risks. DAPT and TATT are the current, safest and best treatment options out now. DAPT is the standard for managing acute coronary syndrome and post stent treatments to prevent clots. Aspirin may be added to provide additional blood

thinning properties. A combination of drugs are used in these patients, these drugs may change, increases the patients risk of bleeding and may continue for months to years. The most common combination being Aspirin and Clopidogrel. TATT treats patients with atrial fibrillation or heart valve issues that require long term anticoagulation use. TATT combines an anticoagulant, most commonly Warfarin, with the DAPT treatment, Aspirin and Clopidogrel. These patients, with the addition of Warfarin, are at a significantly higher risk for major, possibly fatal, bleeding. In the United States, over 2,000 people die from cardiovascular diseases on a daily basis. I was not excited to read this article, but due to the large number of people effected by cardiovascular disease and how risky their medical treatments are, I felt it was important. I want to feel confident and informed if a patient with this condition and possibly in treatment sits down in my dental chair. The article had very good detail about various cardiovascular disease and multiple treatments. It had excellent information on possible medication use in these patients. I was a little disappointed that it did not contain more information specifically how we, the dental professionals, can prepare for or help these patients. The article was also worth 2 CE credits and had a study section included which is always beneficial.