Abstract
A 52-year-old woman with idiopathic interstitial pneumonia was scheduled for a dental teratment in Osaka University Dental Hospital the last year.
At age 44 she complained of dyspnea and palpitation. She was diagnosed to have idiopathic interstitial pneumonia with heart failure and experienced 90-day hospitalization in a general hospital. At age 50 oxygen inhalation therapy for 24 hours a day was initiated. She had ever become powerless and transferred to the hospital four times for two years.
A chest X ray showed cardiac enlargement (CTR 70%) (Fig. 2). An electrocardiogram showed frequent ventricular premature beats and load of the right ventricle (Fig. 1). Fine crackles were heard over the both lower lung field. Physical activity was evaluated to be class III of New York Heart Association classification and class IV of Hugh Jones classification.
Heart rate, blood pressure, electrocardiogram and oxygen saturation were monitored throughout the dental treatment. We prepared to administer antiarrhythmic agents. Although the electrocardiogram revealed frequent ventricular premature beats and paroxysmal supraventricular tachycardias (Fig. 3), we did not use any drugs because she did not complained of unpleasantness. A resin filling was performed in safety. Ten days later she died of respiratory disjunction.
We recognized the risk about dental treatments of medically compromised patients again.
