Yale 2014 - 4 - Atrial Fibriliation - BPM Flashcards Preview

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Flashcards in Yale 2014 - 4 - Atrial Fibriliation - BPM Deck (6)
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1
Q

What are elements to CHADS2?

A

CHF, HTN, Age >75, Diabetes, Stroke or TIA (=2points)

2
Q

What are some initial diagnostic work-ups for Afib?

A

EKG- irregular rhythm and absent P-waves
CXR- to identify pulmonary disease, PNA, CHF, COPD
CBC- anemia, infection
CMP- sodium, potassium, glucose, kidney function
Echo- heart size, shape, function, valvular dysfunctions
TSH- Hyperthyroidism

3
Q

What is the goal heart rate for Afib patients?

A

Less than 80bpm at rest and less than 110bpm with exercise

4
Q

What are the elements to Afib management?

A

Rate control for most patients with beta blocker or nondihydropyridine calcium channel blocker

Anticoagulation with ASA (for low risk) or warfarin, clopidogrel or dabigatran if CHADS2= 2 or greater

Rhythm control/ cardioversion electrically or pharmacologically with propafenone or amiodarone

5
Q

How do you assess bleeding risk for warfarin?

A
Outpatient bleeding risk index:
Age> 65
Hx of CVA
HX or current GIB
One or more of the following: recent MI, severe anemia,
Hct1.5)

0= low (3% risk)
1-2=intermediate (12% risk)
3-4=high (48% risk)

6
Q

What are contraindications to warfarin?

A

Hypersensitivity to warfarin, severe liver disease, recent trauma or symptoms of active bleeding