ORAL AND MAXILLOFACIAL SURGEON HEAD OF ORAL AND MAXILLOFACIAL SURGERY DEPT./AAUP/AL-ISTESHARI HOSPITAL MFD.RCS(IRELAND),ASSISTANT PROFESSOR- AAUP The American College of Cardiology/American Heart Association (ACC/AHA) 2010 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult defnes HF as a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Patients with untreated or poorly managed HF are at high risk during dental treatment for complications such as cardiac arrest, stroke (cerebrovascular accident),and MI. Incidence and Prevalence The prevalence of HF is significantly increasing, primarily as a result of advances in medical technology in preserving and maintaining life after cardiovascular events. Approximately 6 million people in the United States have HF, with more than 550,000 new patients diagnosed each year. In the United States, approximately 56,000 deaths each year are primarily caused by HF, and it is listed as a contributing cause in 262,000 deaths. Pulmonary edema JVD Pitting edema Finger clubbing