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Clin Phys > 2. Atrial fibrillation > Flashcards

2. Atrial fibrillation Flashcards

1
Q

normal BPM

A

60-100 bpm

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2
Q

atrial fibrillation

A

most common atrial tachyarrythmia
caused by abnormal and irregular heart rhythm in which electrical signals are generated chaotically throughout the atria

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3
Q

AF symptoms

A

fast heart rate
irregular
varies in intensity
can be asymptomatic
palpitation
chest discomfort
dizziness
syncope (lack of consciousness)
shortness of breath
lethargy

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4
Q

common causes of AF

A

CHD
hypertension

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5
Q

treatment for managing symptoms of AF

A

rate control using beta blockers or calcium channel blockers
rhythm control using electrical or pharmacological approach or ablation (scarring inside of heart to break up electrical signals that cause irregular heartbeats)

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6
Q

stroke pathophysiology

A

complication of AF

atrial chamber quivers, causes stagnation of blood (partially ejected), blood clot forms, causes stroke

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7
Q

thrombosis
definition and treatment

A

formation of potentially deadly blood clots that blocks blood supply
arterial/venous

treatment: anticoagulants eg. warfarin

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8
Q

arterial clots

A

stroke (head)
heart attack (heart)
peripheral arterial clot

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9
Q

venous clots

A

pulmonary embolism (chest pain, cough, shortness of breath)
deep vein thrombosis (swelling, pain, warmth, purple discolouration)

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10
Q

haemostasis

A

mechanism that leads to cessation of bleeding from a blood vessel

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11
Q

haemostasis damaged vessel process

A

vWF mediates platelet adhesion to damaged vessel wall and platelet aggregation

platelets bind to vWF by adhesion, releases thrombin (activation), attracts other platelets, fibrinogen links between activated platelets results in plug (aggregation), mesh of fibrin holds clot together

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12
Q

Coagulation tests

A

APTT for intrinsic
PT for extrinsic
INR for PT (international normalisation ratio)

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13
Q

natural anticoagulants

A

protein C
protein S - cofactor for protein C
antithrombin inhibits thrombin and Factor Xa

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14
Q

warfarin

A

anticoagulant agent
reversible, administer vitamin K
interacts w food and other drugs
acts as an inhibitor of the vitamin K cycle and vitamin K-dependent clotting factors in liver

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15
Q

therapeutic range

A

most effective range w/o side effects
(within international normalised ratio)

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16
Q

Stroke risk assessment

A

CHA2DS2-VASc

17
Q

Bleeding risk assessment

A

HAS-BLED
to check if safe to give anticoagulant

18
Q

Blood test BNP normal level in pg/ml

A

> 100 pg/ml considered high

19
Q

left ventricular ejection fraction

A

ejection fraction = stroke volume/end diastolic volume

<50% considered systolic dysfunction

20
Q

echocardiogram

A

checks how heart’s chambers and valves are pumping blood through the heart

21
Q

severity for heart failure classification

A

new york heart association functional classification of heart failure

22
Q

breathlessness

A

caused by fluid in the lungs

23
Q

cardiac resynchronisation therapy

A

monitors heart function, shocks heart when needed, prevents sudden cardiac death, like pacemaker, battery 10-12 years

24
Q

heart failure drug treatment

A

ace inhibitors, angiotension receptor blocker or angiotensin receptor-neprilysin inhibitor
beta blockers
diuretics
aldosterone antagonist
CCB not recommended

25
Q

natriuretic peptides in heart failure

A

compensatory mechanism for RAAS pathway
Measures BNP as marker

26
Q

cardio-renal syndrome

A

RAAS pathway leading to increased renal retention (urine cannot be emptied from bladder) of sodium and water leading to edema

diminished cardiac output -> increased sympathetic activity -> increased force and rate of myocardial contraction -> increased cardiac workload -> myocardial dysfunction

27
Q

edema

A

swelling caused by too much fluid in tissues

usually feet swelling due to interstitial fluid stagnating lower due to gravity

28
Q

tachycardia

A

heart rate over 100bpm

Clin Phys (14 decks)

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