Atrial Fibrillation Flashcards
how do you risk stratify patients for VTE?
CHADS2VASc score
what is the CHADS2VASc score?
C = congestive cardiac failure
H = hypertension
A2 = >75 years
D = diabetes mellitus
S2 = previous stroke or TIA
V = vascular disease
A = 65-74 years
Sc = female
2 beside letter = 2 points
who should be anticoagulated?
- males who score >/=1
- females who score >/=2
according to the CHADS2VASc
how do you assess risk of bleeding?
HASBLED or ORBIT
what is HASBLED?
H = hypertension
A2 = abnormal renal or liver function
S = stroke
B = major bleed
L = labile INR
E = elderly
D = drugs/alcohol (1 point for each)
2 beside letter = 2 points
what are the different classifications for atrial fibrillation?
- first detected episode
- paroxysmal
- persistent
- permanent
what is paroxysmal AF?
recurrent episodes of AF which terminate spontaneously
describe persistent AF
- non self-terminating AF
- episodes usually last >7 days
describe permanent AF
continuous AF which cannot be cardioverted or if attempts to do so are deemed inappropriate
what are the symptoms of atrial fibrillation?
- palpitations
- dyspnoea
- chest pain
what are the signs of atrial fibrillation?
irregularly irregular pulse
what does this ECG show?
- irregularly irregular rhythm
- no p wave activity
what are the key parts of managing AF?
- rate/rhythm control
- reducing stroke risk
what are the first-line drugs used in rate control in AF?
- beta-blocker
- rate-limiting calcium channel blocker (e.g. diltiazem)
what are the seond-line drugs used in rate control in AF?
combination therapy with any 2 of the following:
* betablocker
* diltiazem
* digoxin
