[Cardiac arrest in dental offices. Report of six cases].
The extreme medical emergency situation in the dental setting is cardiac arrest. The need to provide dental treatment to the medically compromised patients, suffering from very high risk heart diseases at special oral medicine hospital dentistry units, expose the dental and medical teams to the possibility of patients' death. Cardiac and cardiorespiratory arrest in these units faces the dentists with the need to perform basic and/or advanced cardiopulmonary resuscitation (CPR). Various etiologies are responsible for cardiac arrests. This article describes our experience and the outcome of six patients who have suffered cardiac arrests pre, during or post dental treatment in two special oral medicine centers. Two patients, suffering from severe congestive heart failure experienced fatal ventricular arrhythmia, both of them underwent CPR with early cardiac defibrillation, following which one patient completely recovered, and the other one expired. Two young and healthy patients experienced severe neurocardiogenic syncope with heart standstill for more than 40 seconds followed by spontaneous uneventful recovery. The fifth patient, who suffered from ventricular fibrillation as a result of an acute coronary ischemia, was resuscitated successfully. The last patient, a young woman, suffered from a severe status epilepticus causing bradycardia, which led to cardiac arrest, but recovered following CPR. All patients who did not recover spontaneously underwent methodical advanced CPR with early defibrillation. Only one patient out of the six died.
Findler
M
M
Dept. of Hospital Oral Medicine, Hebrew University, Hadassah School of Dental Medicine, Jerusalem.
Galili
D
D
D000328:Adult; D022561:Advanced Cardiac Life Support; D000368:Aged; D001919:Bradycardia / Q000209:etiology / Q000628:therapy; D016887:Cardiopulmonary Resuscitation; D002318:Cardiovascular Diseases / Q000150:complications; D017742:Dental Care for Chronically Ill / Q000009:adverse effects*; D003770:Dental Offices; D004554:Electric Countershock; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019462:Syncope, Vasovagal / Q000209:etiology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy