Acute cardiovascular complications in patients with diabetes and hypertension: management consideration for minor oral surgery.
| Autor: | Jadhav AN; Department of Dentistry, Jamia Islamia Ishaatul Uloom (JIIU)'s Indian Institute of Medical Science & Research Medical College, Jalna, India., Tarte PR; Department of Dentistry, Jamia Islamia Ishaatul Uloom (JIIU)'s Indian Institute of Medical Science & Research Medical College, Jalna, India. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the Korean Association of Oral and Maxillofacial Surgeons [J Korean Assoc Oral Maxillofac Surg] 2019 Aug; Vol. 45 (4), pp. 207-214. Date of Electronic Publication: 2019 Aug 28. |
| DOI: | 10.5125/jkaoms.2019.45.4.207 |
| Abstrakt: | Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality. Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported. |
| Databáze: | MEDLINE |
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