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Aortic Stenosis Dental Precautions — MFDS Part 1 MCQ

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ModerateHuman DiseaseAortic Stenosis Dental PrecautionsMFDS Part 1

A 70-year-old patient with moderate aortic stenosis is medically stable, has no angina, breathlessness or exertional syncope, and has been assessed by their cardiologist as suitable for routine restorative dental treatment under local anaesthesia. Which precaution is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Use slow chair-position changes and observe for symptoms of presyncope

The correct answer is C. Aortic stenosis restricts the ability to increase cardiac output when systemic pressure or venous return falls. Moving rapidly from a reclined to an upright position can reduce cerebral perfusion and precipitate presyncope or syncope, so chair movements should be gradual and the patient observed for dizziness. The stem excludes angina, breathlessness and exertional syncope, which would require further medical assessment rather than routine elective care. General anaesthesia is not routinely required, and effective local anaesthesia should not be withheld because pain and anxiety can themselves produce adverse cardiovascular responses. NICE guidance does not recommend routine antibiotic prophylaxis for dental procedures solely because a patient has native aortic stenosis.

Reference: Kleczyński P, et al. Predictors of syncope in patients with severe aortic stenosis: The role of orthostatic unload test. Cardiology Journal. 2020;27(6):749–755. https://pubmed.ncbi.nlm.nih.gov/30234894/