Cardiovascular disease
Consider symptoms, exercise tolerance, medicines and the procedure's stress and bleeding implications. Seek medical advice when unstable.
Understand
Cardiac conditions vary from stable disease to unstable symptoms requiring medical assessment. Antithrombotics, implanted devices, exercise tolerance and infective endocarditis context may change planning.
Assess
Ask about recent chest pain, breathlessness, syncope, admissions and medication changes. Clarify the exact condition rather than relying on a broad term such as “heart problem”.
Apply
Defer elective work when symptoms suggest instability, and coordinate appropriate care. Apply current guidance to antibiotic prophylaxis rather than prescribing routinely for every murmur or device.
Key distinctions
Cardiovascular assessment should identify unstable symptoms, functional limitation, recent events and medicines. A history of valve disease does not automatically mean dental antibiotic prophylaxis; current guidance and the individual's risk govern the decision. Implanted devices may affect equipment considerations in selected cases. Clarify which intervention is elective and which cannot safely wait.
Think through a case
A patient reports new exertional chest pain while attending for an elective crown. Medical assessment takes priority over the planned procedure.
The distinction to remember
Do not treat all “heart disease” as identical; stability and current symptoms determine urgency.
Test your recall
Why defer elective care in a patient with new chest pain?
Show answer
It may signal unstable cardiac disease needing assessment.