Atrial fibrillation Flashcards Preview

Year 3: Cardio > Atrial fibrillation > Flashcards

Flashcards in Atrial fibrillation Deck (18)
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1
Q

define atrial fibrillation?

A

cardiac arrhythmia characterised by rapid, chaotic and ineffective atrial electrical conduction. Often subdivided into
o Permanent - continuous AF that cannot be cardioverted.
o Persistent when episodes of AF are not self-terminating lasting more than 7 days
o Paroxysmal when episodes of AF terminate lasting less than 7 days

2
Q

systemic causes of AF?

A

o Thyrotoxicosis
o Hypertension
o Pneumonia
o Alcohol

3
Q

heart causes of AF?

A
o	Mitral valve disease  
o	Ischaemic heart disease  
o	Rheumatic heart disease  
o	Cardiomyopathy 
o	Pericarditis 
o	Sick sinus syndrome 
o	Atrial myxoma
4
Q

lung causes of AF?

A

o Bronchial carcinoma

o PE

5
Q

what is the epidemiology of atrial fibrillation?

A

• VERY COMMON in the elderly

6
Q

presenting symptoms of AF?

A
  • Often ASYMPTOMATIC
  • Palpitations
  • Dyspnoea
  • Chest pain
  • Syncope
7
Q

what are the signs of AF on physical examination?

A
  • Irregularly irregular pulse

* Difference in apical beat and radial pulse

8
Q

first line investigation for AF with results?

A

• ECG - will be irregularly irregular

9
Q

what might the bloods show for AF?

A

o Cardiac enzymes
o TFT
o Lipid profile
o U&Es, Mg2+ and Ca2+

10
Q

what might an echo show in AF?

A
  • Mitral valve disease
  • Left atrial dilatation
  • Left ventricular dysfunction
  • Structural abnormalities
11
Q

what are the three main aspects of management in AF?

A
  • RATE CONTROL
  • RHYTHM CONTROL
  • STROKE RISK prevention
12
Q

how can rate be controlled?

A
    1. Beta blockers (NOT FOR ASTHMA)
    1. CCBs
    1. Digoxin (preferred if patient has heart failure)
13
Q

how can the rhythm be controlled?

A
  • DC cardioversion
  • Amiodarone
  • Flecainide
  • Consider pill-in-the-pocket
14
Q

how can AF patients be managed for stroke risk?

A

o LOW RISK patients can be managed with aspirin

o HIGH RISK patients require anticoagulation with warfarin

15
Q

what is the chad vase score?

A

Stroke 2
Age>75 2
Diabetes 1

Congestive heart failure 1 
Hypertension 1 
Age 65-74 1 
Vascular disease  1
Sex (female =1)
16
Q

how to interpret the chad-vast score?

A
0 = no treatment 
1 = males consider anticoagulant 
2= offer anticoagulant
17
Q

complications of AF?

A

• THROMBOEMBOLISM

18
Q

what is the prognosis for patients with AF?

A

• Chronic AF does not usually return to sinus rhythm