Atrial Fibrillation Flashcards
What is atrial fibrillation?
Disorganised atrial electrical discharge, often originating at pulmonary vein insertion
Causes dilated atria and fibrosis
Causes fast and irregular heart beat
What prior events can cause AF?
hypertension primary heart disease e.g. coronary artery disease lng disease excessive alcohol hyperthyroidism heart failure
How does rheumatic fever in a child lead to AF?
Immune response to strep. pharyngitis damages the heart valves
wear and tear on the valves as you age means atria don’t properly close
Symptoms
Palpitations
Tired/breathless with exercise
chest tightness (angina)
ankle swelling (oedema)
Signs
Irregularly irregular pulse (random strength and random rate)
Signs of underlying cause. e.g. hypertension, lung disease, murmur, weight loss with overactive thyroid)
What are the potential causes of palpitations?
Anxiety (causes muscle tension and shortness of breath)
Age
AF
Mitral stenosis
Abnormal test results
ECG - irregularly irregular rhythm
No P wave ((atrial electricity))
How does warfarin thin blood?
Anticoagulant
Interferes with factors 10, 9, 7 and 2
Interfers with Vitamin K metabolism
REMEMBER 1972
What would warfarin be used to try to prevent?
Pulmonary embolism
Medical intervention
Rate control - digoxin, beta blockers, verapamil
Rhythm control - DC cardio version (electric shock)
Pulmonary veins can be electrically isolated for left atrium by surgery
What is paroxysmal AF? What is the treatment?
Spontaneously reverts to sinus rhythm
treatment is prophylactic
What is prophylactic treatment?
Intends to prevent disease
What is established persistent AF? What is the treatment?
Sinus rhythm might be possible
Treatment is medical or DC conversion
What is established permanent AF?
Sinus rhythm not possible
Treatment is rate control
What might an echocardium show?
Irregular atrial contraction
regurgitation
Dilated atria
