אוטם עקב עקירת שן ?

שלום. עברתי עקירת שן טוחנת בבוקר ואחר הצהרים קיבלתי אוטם שריר הלב רופא השיניים השתמש בזריקה ללא אדרנלין שמכווץ כלי דם . האם לדעתך יש קשר בין העקירה לאוטם ? האם ידוע כל כך ברפואה שעקירה יכולה לגרום לאוטם שריר הלב ? תודה

שלום רב, השאלה מעניינת. חיפשתי במאגרי מידע ואין ספרות רפואית המקשרת בין התופעות כך שאין קשר או אם יש הוא נדיר. מקור לחיפוש הינו האתר http://www.ncbi.nlm.nih.gov מצורף מאמר בנושא ומספר מאמים נוספים: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jun;93(6):647-53. A systematic review of cardiovascular effects of epinephrine on hypertensive dental patients. Bader JD, Bonito AJ, Shugars DA. School of Dentistry, Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. jim_baderunc.edu OBJECTIVE: A systematic review was conducted to identify any additional risks of adverse cardiovascular outcomes to hypertensive individuals represented by use of epinephrine-containing anesthetic solutions AND epinephrine-impregnated retraction cords. STUDY DESIGN: Two searches identified 373 local anesthetic and 33 retraction cord reports; 6 local anesthetic reports met inclusion criteria. RESULTS: Use of epinephrine in uncontrolled hypertensive patients was associated with small, nonsignificant increases in systolic AND diastolic blood pressure. No adverse outcomes were reported. Only one study examined effects of epinephrine on controlled hypertensive patients, in whom additional risks due to interactions with antihypertensive medication are possible. Available studies did not address effects of gingival retraction cord on hypertensive patients. CONCLUSIONS: Although the increased risk for adverse events among uncontrolled hypertensive patients was found to be low AND the reported occurrence of adverse events in hypertensive patients associated with the use of epinephrine in local anesthetics was minimal, the quantity AND quality of the pertinent literature is problematic. PMID: 12142870 [PubMed - indexed for MEDLINE] Related Links Vasoconstrictors AND the heart. [J Calif Dent Assoc. 1998] PMID:9879236 Effects of dental local anaesthetics in cardiac transplant recipients. [Br Dent J. 2002] PMID:11863154 Hemodynamic responses to epinephrine-containing local anesthetic injection and to emergence from general anesthesia in transsphenoidal hypophysectomy patients. [J Neurosurg Anesthesiol. 2004] PMID:15211155 Cardiovascular response to epinephrine-containing local anesthesia in patients with cardiovascular disease. [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001] PMID:11740477 Electrocardiographic changes in cardiac patients having dental extractions under a local anesthetic containing a vasopressor. [J Oral Maxillofac Surg. 1998] PMID:9846537 בברכה, דר' אריאל רוגין