Question 1

Which of the following is the most common reason for decompensation of previously well-compensated heart failure during dental treatment?&#10;A) tachycardia due to anxiety&#10;B) failure to take medications as prescribed&#10;C) orthopnea due to chair position&#10;D) lack of sufficient oxygen saturation due to use of the rubber dam

Accepted Answer

The most common reason for decompensation is the patient's failure to take prescribed medications properly.The dentist must maintain awareness of the patient's clinical status,including medication compliance,with use of close monitoring as appropriate,and be prepared for an emergency.

Question 2

The outstanding symptom of left ventricular heart failure is ________.&#10;A) dyspnea&#10;B) dysphagia&#10;C) cyanosis&#10;D) rales

Accepted Answer

The outstanding symptom is dyspnea,which results from the accumulation or congestion of blood in the pulmonary vessels-hence the designation congestive.Acute pulmonary edema often is the result of left ventricular failure.Left-sided heart failure leads to pulmonary hypertension,which increases the work of the right ventricle,pumping against increased pressure,often culminating in right-sided heart failure.

Question 3

Which of the following is the most common underlying cause of heart failure in the United States?&#10;A) dilated cardiomyopathy&#10;B) coronary heart disease&#10;C) valvular heart disease&#10;D) hypertension

Accepted Answer

The most common underlying cause of heart failure in the United States is coronary heart disease,or coronary artery disease (secondary to atherosclerosis),accounting for 60% to 75% of cases,with cardiomyopathy,hypertension,and valvular heart disease also well-recognized contributory conditions.The second most common cause of heart failure,accounting for about one fourth of all cases,is dilated cardiomyopathy.

Question 4

Most of the acquired disorders that lead to heart failure result in initial failure of the ________.&#10;A) bundle of His&#10;B) mitral valve&#10;C) right ventricle&#10;D) left ventricle

Accepted Answer

Left ventricular heart failure (LVHF)often is followed by failure of the right ventricle.In adults,left ventricular involvement is almost always present,even if the clinical manifestations are primarily those of right ventricular dysfunction (fluid retention without dyspnea or rales).

Question 5

Which of the following categories of drugs is considered to be first-line therapy for the treatment of heart failure?&#10;A) digitalis glycosides&#10;B) &#946;-adrenergic blockers&#10;C) angiotensin-converting enzyme (ACE) inhibitors&#10;D) angiotensin receptor blockers (ARBs)

Accepted Answer

The ACE inhibitors are first-line drugs for treatment of heart failure,and have been shown to reduce the risk of death and the need for hospitalization by 20% to 30%.These agents,which typically are prescribed along with or after diuretic therapy,decrease the need for large doses of diuretics and limit some of the adverse metabolic effects of the diuretics.

Deck 6: Heart Failure or Congestive Heart Failure