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CARDIOLOGY > ATRIAL FIBRILLATION > Flashcards

ATRIAL FIBRILLATION Flashcards

1
Q

What is Atrial Fibrillation?

A

The uncoordinated, rapid and irregular heart rate between the atria and ventricles

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2
Q

What are the three types of atrial fibrillation?

A

Paroxysmal - sudden episode revolving within 7days

Persistent - continuous episode lasting beyond 7days

Permanent - no resolution following treatment

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3
Q

What are the common causes of Atrial Fibrillation?

A

Sepsis

Mitral Valve Pathology

Ischaemic Heart Disease

Thyrotoxicosis

Hypertension

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4
Q

What is Mitral Regurgitation?

A

a condition in which the mitral valve doesn’t close tightly so it allows blood to flow backward into the heart

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5
Q

What are the presenting symptoms for AF?

A

Fatigue, weakness, syncope

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6
Q

What are the physical signs of AF?

A

Palpitation, hypotension, chest pain, bradypnoea and irregular pulse

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7
Q

What are the risk factors of AF?

A

Increased age

Diabetes

Hypertension

Atrial Flutters

Hyperthyroidism

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8
Q

How does an ECG differentiate Atrial Fibrillation from an Atrial Flutter?

A

Absent P wave with tooth appearance in inferior leads and regular-irregular QRS complexes

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9
Q

What are the investigations you would do if you suspect AF?

A

ECG - absent P wave and irregular QRS complex

ECHOCARDIOGRAM- dilated left atrium, valvular disease, low LVEF

Blood Test - serum electrolytes = altered potassium and low magnesium; TFT; cardiac Biomarkers = elevated creatinine Kinase-MB or troponin

CXR - left atrial enlargement, signs of pneumonia, pericarditis, HF

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10
Q

How is a AF managed?

A

Beta blocker - Propranolol

CCB - Diltiazem or Verapamil

Digoxin

Anti-arrhythmic - Flecanide or Amiodarone

Cardiac difibrillator

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11
Q

What are the two choices of Cardioversions?

A

Immediate - AF <48hrs and unstable

Delayed - AF >48hrs and stable

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12
Q

When would you use an Anticoagulant in AF?

A

3wks before Delayed Cardioversion

After a CHA2DS2-VASc has been done

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13
Q

What does CHA2DS2-VASc stand for?

A

CHF

Hypertension

Age >75yo (2points)

Diabetes

Stroke or TIA previously (2points)

Vascular Disease

Age 65-74

Sex (female)

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14
Q

What is the needed score on CHA2DS2-VASc to begin anticoagulant?

A

1 - consider if

> 1 - offer anticoagulant

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15
Q

Which anticoagulant is used to prevent the development of a stroke or TIA in AF?

A

Warfarin or DOAC (apixaban or Dabigatran)

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16
Q

Why is DOAC preferred over Wafarin?

A

no monitoring required

No major interaction problems

Equal or slightly better at preventing strokes and less risk of bleeding

17
Q

How do you assess for likeliness of bleed on anticoagulant?

A

HAS-BLED tool

Hypertension

Abnormal renal and liver function

Stroke

Bleeding

Labile INR (whilst on wafarin)

Elderly

Drugs or alcohol

CARDIOLOGY (8 decks)

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