Atrial fibrillation

Question 1

Complications of atrial fibrillation

Answer 1

1. It causes a reduced cardiac output
2. It can have a more worrying underlying cause
3. Increased risk of Cerebrovascular incident i.e. stroke and TIA

Question 2

Symptoms of AF

Answer 2

Palpitations
SOB
Dizziness
Chest pain

Question 3

Signs of AF

Answer 3

Irregular pulse
Hypotension (some not all)
Heart failure signs e.g. oedema

Question 4

Risk factors for AF

Answer 4

• HTN
• Mitral diseases
• Pulmonary diseases
• Alcohol
• Thyroid disease

Question 5

Investigations for AF

Answer 5

• FBC, U+Es, VBG
• cxr
• Echo to look for valvular disease
• Troponin
• If suspected paroxysmal - 24h ECG

Question 6

When is AF deemed unstable/likely features of unstable AF?

Answer 6

• Acute onset
• HR over 100bpm

Question 7

How is unstable AF treated

Answer 7

DC cardioversion and amiodarone

Question 8

Atrial fibrillation management

Answer 8

• Treat underlying cause
• Rate control (beta blocker)
• Rhythm control (flecanide/amiodarone)
• Manage stroke risk (CHADs-VASc2 score) to determine if they need a DOAC

Question 9

What is the CHADs-VASc2 score?

Answer 9

Congestive Heart Failure (one point)
High blood pressure (one point)
Age (two points if above 75, one point if between 65 and 74)
Diabetes (one point)
Previous stroke/TIA or clot (two points)
Vascular disease (one point)
Sex (one point if female)