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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.