Stenosis
Unusual narrowing of the blood vessels or other tubular structures or organs is referred to as stenosis. In simple words stenosis means narrowing of the various body parts. The common causes for stenosis include birth defects, inflammation, neoplasm (abnormal proliferation of cells), ischemia (reduction of blood supply thus damaging tissues), infection, iatrogenic (complications arising from any treatment) and atherosclerosis.
Spinal stenosis: Specific causes include rheumatoid arthritis, osteoarthritis, aging, spinal injury or tumor and spondylosis. Symptoms include pain and weakness in the legs along with cramps, imbalance and loss of control over bladder and bowel movements.
Mitral valve stenosis: Specific causes include endocarditis, atrial myoxma, rheumatic fever and Lutembacher syndrome. Symptoms of mitral valve stenosis are fatigue, recurrent respiratory infections and swelling in the feet.
Aortic valve stenosis: This type of stenois may be caused by rheumatic fever, Williams syndrome, LDL receptor deficiency and senile or bicuspid aortic valves. The typical symptoms of aortic valve stenosis are chest pain and heart murmur, fatigue and shortness of breath and heart palpitations.
Pulmonary valve stenosis: Specific causes include deformity during fetal development, rheumatic fever and endocarditis. This type of stenosis is symptomized by cough and fatigue, fluid retention and shortness of breath.
Treatment differs according to the type of stenosis. While physical therapy, drugs like analgesics and lumbar brace are used to manage spinal stenosis, aortic valve stenosis and pulmonary valve stenosis are treated with valve replacement surgery.
Septicemia
Septicemia is a life-threatening infection; where there is bacteria in the blood. This is a form of blood poisoning and the fatality rate is nearly 50%. It is also called a systemic inflammatory response syndrome or SIRS where the whole body is inflamed due to suspected infection. Severe sepsis leads to organ failure. Infections in the lungs, urinary tract or abdomen can lead to sepsis. Other conditions that can lead to septicemia are endocarditis, meningitis and osteomyelitis. Symptoms of sepsis begin with chills, high fever and rapid breathing. The condition worsens rapidly with hypothermia and low blood pressure setting in. There is very low urine output. Blood test for platelet count, CBC, blood gases and PTT are done. CSF culture is also done to diagnose sepsis. Treatment of septicemia involves hospitalization. IV fluids and medications are administered. Plasma is often given when clotting factors are affected. Dialysis and mechanical ventilation might be required to support the kidney and lung function.
Flossing and Heart Disease
A global protocol followed among all dentists and oral care providers is the association between oral health and systemic diseases. Comprehensive screening with thorough assessment of oral hygiene can create a good prophylaxis and also determine the relationship between oral health and systemic diseases. Research has proven that the link between oral health and systemic inflammatory diseases can be evaluated to assess the deteriorating effects on the organ systems.
Inflammatory response
The inflammatory response patterns that manifest in the body are redness, swelling, pain and loss of function. The process of inflammation predominantly affects the periodontium. The biofilm formed may contain bacteria of different types mainly gram positive and gram negative in origin. The microorganisms colonize in the regions of interproximal spaces and gingiva releasing exotoxins, cytotoxins and also protein toxins respectively. In the process of infection the visible changes appear which include bleeding gums, redness etc. This phenomenon is called periodontitis. Prolonged cased of periodontitis can eventually cause coronary diseases such as atherosclerosis.
These conditions occur because of the proliferation of soluble compounds and the release of interleukins and tumor necrosis factors and prostaglandins. The local inflammation thus formed begins to sustain by chemical mediators leading to the development of atherosclerotic lesion. The lesion progresses and the action of extra cellular proteolytic enzymes may cause rupture. This may lead to the formation of thromboses facilitating the blood flow into the heart causing infarction. The identification of inflammatory markers may help in effective diagnosis.
Oral conditions causing heart disease
- Poor oral health and improper assessment of oral hygiene associated disease can progress to cardiovascular disease.
- Patients with a history of gum disease are at a risk of developing a heart disease.
- Patients with fewer teeth due to tooth decay are susceptible to coronary conditions.
- Alcohol, smoking, diabetes can also lead to deterioration of oral hygiene which may result in coronary conditions.
Development of coronary condition due to poor oral hygiene is mainly associated with the type of inflammatory response generated due to infection in the oral cavity. The research on periodontitis associated heart disease is still underway and the plausible theory of oral hygiene and systemic diseases is slowly being ruled out by extensive study carried out in the respective area.
Flossing
Since the development of heart disease is related to oral hygiene, one of the effective methods to avoid inflammatory conditions suggested by dental care experts is through flossing. Flossing regularly can prevent the onset of periodontitis which occurs due to plaque and tooth decay. The type of floss recommended may be multi filament nylon or monofilament PTFE in origin. The floss is generally coated with waxy layer to avoid the damage or tearing of gums. The method of flossing has to be carefully followed as it may sometimes erode or lead to bleeding of the gums which may also be associated with the travel of formed blood clots in to the heart. Preexisting heart conditions may also lead to the development of bacterial endocarditis due to poor oral hygiene. Other conditions associated are myocardial infarction, congenital heart valve defects and also hypertrophic cardiomyopathy.
- Inform your doctor about medications that you are taking for any health problem or underlying history of heart disease.
- In case of the use of blood thinning medications, the dentists and cardiologists have to be notified.
- Good oral hygiene such as brushing and flossing is suggested to the patients.
Bibliography / Reference
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