Heart Attack/Myocardial Infarction – Medical Disorders

Medical Disorders

Myocardial Infarction (MI)/Heart Attack

Clinical Criteria for MI (see Thygesen K, et al. below)

The clinical definition of MI denotes the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia.

Criteria for Myocardial Injury (see Thygesen K, et al. below)

Detection of an elevated cTn (cardiac troponin) value above the 99th percentile URL is defined as myocardial injury. The injury is considered acute if there is a rise and/or fall of cTn values.

When was your heart attack and your last cardiac evaluation, and what is your present status?

A heart attack is an irreversible ischemic event that results in death of myocytes (myocardial necrosis or infarction), which can be further defined according to a clinical classification.

Patients undergoing cardiac rehabilitation, including revascularization and medical therapy, after an heart attack are usually stable enough to undergo routine dental care 30 days after their heart attack, unless they have residual heart failure. This must be verified with the patient’s cardiologist.

The dental protocol for patients who have had a heart attack within the previous month is different than the dental protocol for patients more than 1 month after a heart attack.

⚠️ Do not provide elective dental care for patients within 1 month of a heart attack.

Do you have any signs or symptoms of cardiovascular disease?

Patients exhibiting signs and symptoms including decompensated heart failure, stable or unstable angina, or dysrhythmias may not be stable enough for routine dental care even after 30 days of a heart attack.

⚠️ Do not provide elective dental care for patients after a recent heart attack if they experience decompensated heart failure, recent symptoms of unstable angina or dysrhythmias.

What medications are you taking?

Side effects of medications may include increased bleeding and gingival overgrowth.

Be aware that chronic use of non-steroidal anti-inflammatory drugs may increase the risk of cardiovascular events in elderly patients with hypertension.

Related Pages

References/Websites