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BS - Cardiovascular System > Atrial Fibrillation > Flashcards

Atrial Fibrillation Flashcards

1
Q

Which anatomical structures are affected in atrial fibrillation?

A

The right and left atria

The pulmonary veins where they meet the left atrium

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2
Q

What physiology is affected in atrial fibrillation?

A

The pacemaker activity of the heart

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3
Q

How does atrial fibrillation affect the ventricles?

A

The conduction of electrical depolarisation through the atrium is affected

This affects stimulation of electrical activity in the ventricles

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4
Q

What structural abnormalities are present in atrial fibrillation?

A

The atria are dilated

There is fibrosis (scarring) of the atrial muscle

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5
Q

How is pacemaker activity of the heart affected in atrial fibrillation?

A

The SA node is overwhelmed by disorganised electrical discharge

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6
Q

Where does the disorganised electrical activity usually originate from?

A

at a pulmonary vein insertion

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7
Q

What 6 prior events may lead to atrial fibrillation?

A
  1. hypertension
  2. primary heart diseases
  3. lung diseases
  4. excessive alcohol consumption
  5. hyperthyroidism
  6. heart failure
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8
Q

What symptoms are experienced by the patient?

A
  1. palpitations
  2. tired and/or breathless with exercise
  3. sometimes chest tightness (angina)
  4. sometimes ankle swelling (oedema)
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9
Q

What is meant by heart palpitations?

A

This is awareness of the heart beat

It may be fast, irregular or both

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10
Q

What clinical signs may be seen in a patient with atrial fibrillation?

A
  1. irregular pulse

2. signs of an underlying cause

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11
Q

What signs of an underlying cause may be seen?

A
  1. high blood pressure
  2. lung disease
  3. valve murmur heard with stethoscope
  4. weight loss with overactive thyroid
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12
Q

What abnormal test results may be seen in a patient with AF?

A

ECG - there are no clear P waves

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13
Q

What 3 methods of medical/surgical intervention are used to treat AF?

A
  1. rate control
  2. rhythm control
  3. electrically isolating the pulmonary veins from the elft atrium
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14
Q

Which drugs are used to control the heart rate?

A

digoxin, beta-blockers, verapamil

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15
Q

What is the aim of treatment through rate control?

A

This seeks to slow down the heart rate to prevent palpitations and to improve the efficiency of the heart beat

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16
Q

Which drugs/other treatments are used to control the heart rhythm?

A

drugs - amiodarone

DC (direct current) cardioversion is electrical shock treatment

17
Q

What is the aim of treatment for AF through rhythm control?

A

This seeks to convert the heart rhythm back to normal, regular sinus rhythm

18
Q

How can the pulmonary veins be electrically isolated from the left atrium?

A
  1. surgery
  2. catheter - placing a tube in the heart from the arm/leg
  3. ablation
19
Q

What is ablation?

A

Use of an energy pulse which makes the atrial cells unable to conduct electricity

20
Q

How can patients work to try and prevent AF?

A

Avoid consuming an excess of alcohol and stimulants such as nicotine and caffeine

21
Q

What is the most effective way of preventing AF?

A

Early and effective treatment of diseases that causes atrial fibrillation

e.g. high blood pressure, lung diseases

22
Q

Why is warfarin used in AF patients?

A

It prevents the formation of blood clots in the atrium

23
Q

What is the downside of using aspirin occasionally as an alternative to warfarin?

A

It is less effective in preventing blood clot formation and embolisation

24
Q

What is embolisation?

A

Movement of a blood clot from the atrium to the body

25
Q

What happens if an embolus forms in the brain?

A

This causes a stroke due to death of brain tissue

26
Q

What happens if an embolus forms in the leg or bowel?

A

Ischaemia due to lack of blood

or

Necrosis due to death of tissue

BS - Cardiovascular System (20 decks)

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