Atrial Fibrillation/ Flutter Flashcards
what is atrial fibrillation
characterised by rapid, chaotic and ineffective atrial electrical conduction.
what can you subdivide atrial fibrillation into
permanent, persistent and paroxysmal
aetiology
problem in the conduction pathway. primarily abnormalities such as dilation and fibrosis of the atria
what categories are risk factors for AF split into
can be split into: systemic, cardiac and pulmonary causes
systemic causes
Thyrotoxicosis Hypertension Pneumonia Alcohol diabetes old age
cardiac causes
Mitral valve disease Ischaemic heart disease Rheumatic heart disease Cardiomyopathy Pericarditis Sick sinus syndrome Atrial myxoma
pulmonary causes
COPD,
obstructive sleep apnoea,
pulmonary embolism
bronchial carcinoma
epidemiology
very common in the elderly, occurs in 5% od those above 65 and can be paroxysmal
presenting symptoms of AF
can be asymptomatic/ an incidental finding Palpitations, irregular pulse rate, breathlessness, symptomatic hypotension, chest pain, fatigue, anxiety
signs on examination
irregular pulse rate,
difference in apical beat and radial pulse
investigations to perform on suspected AF
ECG, FBC, clotting profile, urea, electrolytes and creatinine, thyroid function, CXR Transthoracic echocardiogram
ECG findings
Uneven baseline with absent p waves
Irregular intervals between QRS complexes
Atrial flutter = saw-tooth
why do you do urea, electrolytes and creatinine
CKD is a risk factor which can precipitate AF
what two electrolytes are really important to look at
Mg2+ and Ca2+
Because there is increased risk of digoxin toxicity with hypokalaemia, hypomagnesaemia and hypercalcaemia
what may the echocardiogram show
may show dilated left atrium; valvular disease; low left ventricular ejection fraction; diastolic dysfunction
