Atrial Fibrillation

Descrição

Pham1008 Mapa Mental sobre Atrial Fibrillation, criado por Affy MD em 02-05-2013.
Affy MD
Mapa Mental por Affy MD, atualizado more than 1 year ago
Affy MD
Criado por Affy MD mais de 11 anos atrás
58
1

Resumo de Recurso

Atrial Fibrillation
  1. Risk Factors

    Anotações:

    • NOT FROM LECTURE NOTES
    1. Post-Operative (Open Heart Surgeries)
      1. Pericarditis
        1. "Lone" AF

          Anotações:

          • NO RISK FACTORS at all and still has AF...
          1. Cardiac Causes
            1. Hypertension
              1. Heart Failure
                1. Ischaemic Heart Disease
                  1. Rheumatic Heart Disease
                    1. Sinus-sinus syndrome

                      Anotações:

                      • Tachy-Brady syndrome
                      1. Wolff-Parkinson-White Syndrome
                        1. Cardiomyopathy
                        2. Non Cardiac Causes
                          1. Acute Infections
                            1. Electrolyte depletion
                              1. Lung Carcinoma
                                1. Pleural Effusion
                                  1. Pulmonary Embolism
                                2. What happens in AF
                                  1. It is a type of Arrhythmia
                                    1. Atria are fibrillating, not a normal contraction ---> STAGNANT Blood Flow
                                      1. Leading to a rapid, irregular Ventricular Rate
                                        1. Decreased Ventricular filling and output
                                          1. This leads to these SYMPTOMS
                                            1. Fatigue
                                              1. Shortness of Breath
                                                1. Chest discomfort
                                                  1. Palpitations
                                                    1. Feeling faint
                                                2. Blood Clot
                                                  1. Stroke
                                                    1. Heart Attack
                                                      1. Pulmonary Embolism

                                                        Anotações:

                                                        • Blood Clot in the Lung
                                                3. Rate Control
                                                  1. Medicines
                                                    1. Beta-Blockers & Non-dihydropyridine CCB are first line

                                                      Anotações:

                                                      • Metoprolol, Atenolol, Propranolol, Carvedilol Diltiazem, Verapamil. All DECREASE BP. Slow the HR 
                                                      1. Digoxin - Second line

                                                        Anotações:

                                                        • HR often increase with exercise
                                                      2. Procedures
                                                        1. Pacemakers

                                                          Anotações:

                                                          • Prevents Heart from going too slow but can do nothing with heart going too fast. That is why antiarrhymic drugs are given.
                                                          1. AV node ablation

                                                            Anotações:

                                                            • A type of surgery that involves burning.
                                                        2. Rhythm Control
                                                          1. Medicines

                                                            Anotações:

                                                            • Most likely prescribed these medications for sinus rhythm maintenance or preventing AF occuring
                                                            1. Amiodarone

                                                              Anotações:

                                                              • Best Efficacy/Effectiveness. Problems: Toxicity in brain, liver, kidney, thyroid, skin.
                                                              1. Flecainide
                                                                1. Pill In Pocket
                                                                2. Cardioversion

                                                                  Anotações:

                                                                  • Restarting the heart.  Very successful - AF to normal sinus rhythm 
                                                                3. Diagnosis of AF
                                                                  1. Paroxysmal AF (Self-Terminating)

                                                                    Anotações:

                                                                    • <7 days (Most resolve within 24 hours)
                                                                    1. Rhythm Control FIRST
                                                                      1. Rate Control if rhythm fails
                                                                    2. Persistent AF (Not Self-Terminating)

                                                                      Anotações:

                                                                      • > 7 days - sustained AF that terminates with cardioversion
                                                                      1. Rate OR Rhythm Control depending on conditions

                                                                        Anotações:

                                                                        • Rhythm first in patients who are: Symptomatic Younger (<65) Presenting for first time with Lone AF Secondary to precipitant Congestive Heart Failure 
                                                                        • Rate first in patients who are: Over 65 With Coronary Heart Disease Contraindications to anti-arrythmic drugs Unsuitable for cardioversion 
                                                                        1. Try other if previous fails
                                                                      2. Permanent AF (Cannot go back to Normal)

                                                                        Anotações:

                                                                        • Persists for more than a year, cardioversion has failed or not even attempted
                                                                        1. Rate Control FIRST
                                                                          1. Rhythm Control (if rate fails)

                                                                            Anotações:

                                                                            • Opposite of Paroxysmal  methods Karo :)
                                                                        2. New Onset of AF
                                                                          1. Patient is Hemodynamically Stable
                                                                            1. Anticoagulated INR 2-3 for >3 weeks
                                                                              1. Cardioversion
                                                                                1. Rate Control
                                                                                2. Not anticoagulated INR <2 for 3 weeks
                                                                                  1. Warfarin and Rate Control
                                                                                    1. Cardioversion
                                                                                3. Recurrent AF

                                                                                  Anotações:

                                                                                  • I don't know if we've learnt it this way...
                                                                                  1. Minimal Symptoms
                                                                                    1. Warfarin and Rate Control
                                                                                      1. No prevention. No Anti-arrythmic drugs
                                                                                    2. Disabling Symptoms
                                                                                      1. Warfarin and Rate Control
                                                                                        1. Anti-arrythmic drugs for prevention
                                                                                  2. Warfarin INR 2-3

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