Atrial fibrillation

Question 1

Name 3 causes of atrial fibrillation

Answer 1

IHD, Rheumatic valve disease and thyrotoxicosis

Question 2

In a patient with AF taking warfarin what level INR would you aim for?

Answer 2

2-3

Question 3

what level INR would you aim for if someone had a mechanical mitral valve?

Answer 3

3-4

Question 4

explain the pulse deficit between the apex beat and the radial pulse?

Answer 4

loss of diastolic filling time with fast ventricular rates

Question 5

What symptoms might a patient in AF present with?

Answer 5

palpitations, SOB or reduced exercise tolerance, chest pain, syncope

Question 6

what are the principles of AF management?

Answer 6

The aim is to reduce stroke risk with anticoagulation and control the rhythm disturbance with medication or surgical ablation (ie rate and rhythm control)

Question 7

A patient in heart failure goes into atrial fibrillation what’s the most appropriate urgent management?

Answer 7

DC synchronised cardioversion