Increased CV risk( MI)for dentistry. EXTREME Recent MI Unstable angina Uncompensated CHF Significant arrhythmias ( ventricular) Severe valvular disease AHA. 2002. Circulation. 105:10. Increased CV risk( MI) for dentistry. MODERATE previous MI ANY angina
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By far the most dangerous foe we have to fight is apathy - indifference from whatever cause, not from a lack of knowledge, but from carelessness, from absorption in other pursuits, from a contempt bred of self-satisfaction.Sir William Osler,1900
Pharmacologic treatment.NYHA class I CHF( ejection fraction >40% ;
asymptomatic patient)Long-acting ACE inhibitor
Furosemide ( 20-120 mg)
(watch for hypokalemia and gout)Long-acting ACE inhibitors( enalapril 5-10 mg 2 x/day) Potassium chloride supplementation (>4.0 mEq/L)Consider adding metozalone, 5-10 mg every other day (when furosemide dose exceeds 160 mg/day)