Acute cardiovascular complications in patients with diabetes and hypertension: management consideration for minor oral surgery

• 발행기관: 대한구강악안면외과학회
• 저자명: Ajinath Nanasaheb Jadhav Pooja Raosaheb Tarte
• 간행물 정보: 『대한구강악안면외과학회지』대한구강악안면외과학회지 제45권 제4호, 207~214쪽, 전체 8쪽
• 주제분류: 의약학 > 내과학
• 파일형태: PDF
• 발행일자: 2019.08.30

영문 초록

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.

목차

Abstract

Ⅰ. Introduction

Ⅱ. Materials and Methods

Ⅲ. Results

Ⅳ. Discussion

Ⅴ. Conclusion

References

키워드

Diabetes Hypertension Cardiovascular complications Oral surgery