[AF/flutter] Flashcards
embolic stroke (4%)
warfarin
anyone with an irregular pulse
dizzy
faint
palpitations
(other symptoms)
HTN
alcohol
caffeine
hypokalaemia
low magnesium
MI
mitral valve disease
heart failure
heart ischaemia
pneumonia
PE
Hyperthyroidism
‘lone’ AF
dyspnoea
palpitations
chest pain
faintness
irregularly irregular
T
Absent P waves
irregular QRS complexes
left atrial enlargement
mitral valve disease
reduced LV function
(other structural abnormalities)
benign tumour of the atria.
the measurable degeneration of the ability of the heart to contract due to any cause - usually leading to heart failure
haemochromatosis
the pulse calculated from listening over the apex of the heart with stethoscope
the apical would be greater (this is due inefficient heart contractions which fail to transmit the pulse to a peripheral site. )
absent P waves
irregular QRS complexes
electrolyte imbalance (K and Mg - hypo)
Exclusion of MI
exclusion of hyperthyroidism
within 48 hours
very ill
haemodynamic instability
O2
U&Es
Cardioversion
patient should be in ITU and under GA/IV sedation
GA or IV sedation
- monophasic 200J
- monophasic 360J
- monophasic 360J (biphasic 200J)
Amiodarone IVI 5mg/kg over 1hr
then
Amiodarone IVI 900mg over 24hrs (central line)
alternatively
Amiodarone PO 200mg/8hrs for 1 week
Amiodarone PO 200mg/12hrs for 1 week
Amiodarone PO 100-200mg/24hrs mainenance
flecainide
class Ic anti-arrhythmic drug
sodium channel blocker - use dependent. strong -ve ionotrope
2mg/kg IV over 10-30 minutes
max 150mg
ECG
IHD
WPW
unstable patient
