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Oral health care considerations for patients after a heart attack/myocardial infarction:

Heat attack more than 1 month ago:

  • If the patient is also suffering from decompensated congestive heart failure (CHF), treat patient as if having unstable angina until coronary stability has been verified by the patient’s physician.
  • Arrange for necessary medical attention.
  • Have oxygen and nitroglycerin available.
  • Use additional pain and anxiety control as indicated.
  • Schedule late-morning or early-afternoon appointments.
  • Schedule short appointments.
  • Use local anesthetics judiciously.
  • Use adjunct measures to reduce stress.
  • No contraindication for using epinephrine.
  • Be aware that chronic use of non-steroidal anti-inflammatory drugs may increase the risk of cardiovascular events in elderly patients with hypertension.
  • Address patient’s anticoagulation therapy, if indicated.

Heart attack less than 1 month ago:

  • No elective dental care.
  • For emergency care, use analgesics and antibiotics as indicated.
  • For invasive procedures, consult with patient’s cardiologist and be prepared to use continuous cardiac monitoring