PMID: 16509516Mar 3, 2006Paper

Cardiological (pharmaco)therapy and dental practice

Nederlands tijdschrift voor tandheelkunde
J BrügemannFelix Zijlstra

Abstract

In recent years much progress has been made in the treatment of acute coronary syndromes, heart failure and cardiac rhythm disturbances. Polypharmacy including two antiplatelet drugs (aspirin and clopidogrel) is common in many patients after a percutaneous coronary intervention using a 'stent'. Discontinuation of these drugs for invasive dental treatment may result in coronary rethrombosis. However, in many patients with coronary artery disease, a temporal pause in the use of aspirin appears safe and may decrease the risk of bleeding after a dental procedure. An increasing number of patients with heart failure and/or life threatening rhythm disturbances receive an implantable cardioverter defibrillator (ICD). Such a device, equipped with a left ventricular lead, also stimulates the left ventricle in case of delayed electrical conduction (e.g. a left bundle branch block). This so called cardiac resynchronization therapy decreases morbidity and mortality in selected patients. ICDs are safe in the dental office even in case of discharge. In patients with prosthetic heart valves, endocarditis prophylaxis according to the current guidelines is recommended before invasive dental treatment. Dentists are advised to contact the Dutch Th...Continue Reading

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