Arrhythmia

Question 1

What is the pathology behind atrial fibrillation?

Answer 1

Recurrent, uncoordinated contration @ 300-600bpm as LA loses refractoriness before the end of atrial systole

Question 2

What are some common causes of atrial fibrillation?

Answer 2

IHD
Rheumatic heart disease
Thyrotoxicosis
Hypertension

Question 3

What are some less common causes of atrial fibrillation?

Answer 3

Alcohol, Pneumonia, PE, post op, hypokalaemia, RA

Question 4

What are the symptoms of atrial fibrillation?

Answer 4

Can be non e

Chest pain, palpatations, dyspnoea, faintness

Question 5

What are the signs of AFib?

Answer 5

Irregularly irregular pulse
Fast AF may have no palpable pulse due to loss of diastolic filling
Signs of LVF

Question 6

What cardioversion can be used in acute AF?

Answer 6

Electrical
Pharmacological (1st flecainide if no structural heart disease 2nd amiodarone)

Question 7

What drugs are used for pill in pocket treatment of paroxysmal AF?

Answer 7

Flecainide, propafenone

Question 8

What is the CHA2-DS2-VAS score?

Answer 8

Determines the necessity of anticoagulation in AF

Question 9

What is the outcome of CHAD-VAS?

Answer 9

0 - aspirin 300mg

1 and above - warfarin