Atrial Flutter & Fibrilation Flashcards Preview

Clin Med - Cardio Exam #2 > Atrial Flutter & Fibrilation > Flashcards

Flashcards in Atrial Flutter & Fibrilation Deck (47)
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1

define a.fib

disorganized, rapid, and irregular atrial contraction

2

What does a.fib result in?

- non-effective contractility
- irregular ventricular response
- tachycardia (120-160bpn)
- thrombus/clot

3

What is the MC arrhythmia?

a.fib

4

What is the MC cause of TIA?

a.fib

5

epidemiology of a.fib

- 65+ y/o
- males more than females

6

etiology of a.fib

often related to stretching
- hyperthyroidism
- vagotonic episodes
- ETOH toxicity
- post-op
- atrial enlargement d/t end stage R heart failure
- disruption of electrical conduction system

7

pathophysiology of a.fib

- incr atrial pressure
- triggered by atrial premature beats or other supraventricular arrhythmia
- ectopic foci most commonly located at osteal portion of pulm. v.

8

risk factors for a.fib

- 64+ y/o male
- HTN
- incr BMI
- prolonged PR interval
- valvular dz
- CHF

9

classifications of a.fib

- paroxysmal (PAF)
- persistent
- permanent
- "Lone"

10

describe PAF

intermittent

11

describe persistent a.fib

- does not self-terminate w/in 7d
- requires intervention to convert

12

describe permanent a.fib

12+ mo

13

describe Lone a.fib

- without structural heart disease
- lowest risk of complications

14

diseases associated with a.fib

- valvular dz (sig. stenosis/regurg and rheumatic heart dz)
- heart failure d/t dilation
- hypertensive heart disease
- acute MI

15

symptoms of a.fib

- asx
- heart palpitations
- lightheadedness, pre-syncope, syncope d/t decr BP and incr HR
- SOB + DOE
- chest pain (rare)
- fatigue

16

common triggers of a.fib

- sleep deprivation
- physical illness
- post-op
- stress
- hyperthyroidism
- exercise
- stimulant rx
- ETOH
- caffeine
- dehydration

17

initial presentation of new onset a.fib

- heart palpitations
- fatigue
- SOB
- angina

18

physical exam of a.fib

- decr. BP, incr. HR
- irregularly irregular pulse (check for DVT)
- murmurs
- evidence of heart failure (incr. JVP, crackle, edema)

19

diagnostics for a.fib

- *EKG* = no p waves, irregularly irregular rhythm
- TTE
- TEE (prior to cardioversion)
- exercise stress test (CAD)
- heart monitors

20

labs for a.fib

- *TSH*
- CBC
- BMP

21

goals of therapy for a.fib

- rhythm control
- decr risk of TIA/emboli
- rate control
- alleviate sx

22

indications for urgent DC cardioversion for a.fib

- active ischemia
- unstable hemodynamics
- organ hypoperfusion
- severe manifestations of heart failure (pulm edema)
- WPW syndrome (delta waves)

23

indications for non-urgent DC cardioversion fo a.fib

- new onset or newly recognized
- persistent a.fib who are limited by their sx

24

indications NOT to DC cardiovert for a.fib

- minimally sxatic
- multiple co-morbidities
- pts unlikely to remain NSR
- 80+ y/o
- *paroxysmal a.fib*

25

Prior to _____ for a.fib, control _____ rate and provide _____.

Prior to cardioversion for a.fib, control ventricular rate and provide IV heparin.

26

patient presents with a.fib for less than 48 hrs, what do you do?

heparin + rate control then cardiovert

27

patient presents with a.fib for more than 48 hrs, what do you do?

Option 1: oral anticoags x3wk then cardiovert
Option 2: TEE

28

patient presents with a.fib for more than 48 hrs and you've decided to get at TEE, what are you looking for and what do you do if you find it or not?

No thrombus ==> heparin + cardioversion
Thombus ==> oral anticoags x3wks

29

patient presented 3 weeks ago with a.fib of more than 48hrs for which you got a TEE and saw a thrombus, now what do you do?

repeat TEE
- No thrombus ==> cardioversion
- thrombus ==> long term anticoags + NO cardioversion

30

complications of a.fib with rapid ventricular rate (150+ bpm)

- heart palpitations, fatigue, SOB, etc
- ischemia
- pulm edema
- tachycardia induced cardiomyopathy