Acute cardiovascular complications in patients with diabetes and hypertension: management consideration for minor oral surgery
Journal of the Korean Association of Oral and Maxillofacial Surgeons
;
: 207-214, 2019.
Article
in English
| WPRIM
| ID: wpr-766339
ABSTRACT
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 ANDMETHODS:
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Surgery, Oral
/
Syncope
/
Troponin
/
Chest Pain
/
Cardiology
/
Aspirin
/
Incidence
/
Prospective Studies
/
Mortality
/
Nitroglycerin
Type of study:
Diagnostic study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of the Korean Association of Oral and Maxillofacial Surgeons
Year:
2019
Type:
Article
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