Cardio- A Fib

Question 1

Common symptoms of a fib

Answer 1

Palps fatigue syncope dizziness
Tachycardia
Irregular irregular pulse

Complications of emboli due to long standing afib:
Acute left heart failure
Stroke TIA renal infarct splenic infarct intestinal ischaemi acute limb ischaemia

Question 2

Describe Cha2ds2vas score

Answer 2

C: ccf …1
H: htn ….1
A2: Age greater than 75…..2
D: diabetes… 1
S2: stroke tia prior…2
V: vascular disease like pad MI…1
A: age 65-74…1
S: sex being female… 1

Max score is 9

Question 3

How do you manage a patient with a chadsvas score of 1&2 respectively

Answer 3

Score 1: oral anticoagulant or eg rivaroxaban or dabigatran or well controlled warfarin at INR 2-3
Or ASA 75-325 mg daily

Score 2: oral anticoagulant: same as above just not Asa

Question 4

What is the has-bled score and describe it

Answer 4

Estimates risk of major bleeding in patients already on Anticoagulation for a fib

H: htn … 1
A: abnormal renal or liver function…. 1 each 
S: stroke… 1
B: bleeding… 1
L: labile inr …. 1
E: elderly greater than 65…. 1
D: drugs or alcohol… 1 each 

Max 9 points