Atrial Fibrillation

benryan95's version from 2015-10-19 17:27

Section 1

Question Answer
What is the prevalence ratio for men:women in AF?1.5:1
In resource rich settings, what are the most common associated clinical diagnoses of AF?Hypertension, Coronary Artery Disease, and MI
In resource poor settings, what are the most common associated clinical diagnoses of AF?Congestive Heart Failure, Hypertension and rheumatic valvular disease.
What is meant by paroxysmal AF?Recurrent episodes AF that terminated spontaneously within 7 days
What is meant by persistent AF?AF that is sustained longer than 7 days, or requires cardioversion before then
What is meant by long-standing persistent AF?Continuous AF longer than 1 year in duration
What is meant by permanent AF?Accepted as a final rhythm, decision has been made to not persue restoration of sinus rhythm
What has been shown to reduce the incidence of AF?ACE inhibitors, statins, betablockers/amiodarone pre-cardiac surgery
What are the cardiovascular key risk factors for AF?Coronary artery disease, hypertension, pericarditis, cardiomyopathy, arrhythmias
What are the non-cardiovascular key risk factors for AF?DM, thyroid disease, alcohol abuse, smoking, certain cancers

Section 2

Question Answer
What are common symptoms/signs of AF?Palpitations, tachycardia, irregular pulse
What 1st tests should be ordered for AF?12 lead ECG, thyroid profile, ECHO, serum U+E
What is seen on a 12 lead ECG in AF?Absent P waves, presence of fibrillatory waves, irregularly irregular QRS complexes
Why is a thyroid profile done in AF?Thyrotoxicosis may present with AF
Why is an ECHO done in AF?Important to exclude other cardiac pathologies/risk factors such as valvular, pericardial and cardiomyopathies
What may an ECHO show in AF?Valvular regurgitation, stenosis, left ventricular/atrial enlargemnt, pulmonary hypertension, left ventricular wall thickness and function
Why are serum U+Es done in AF?Important to check serum creatinine as an indicator of renal function

Section 3

Question Answer
What is 1st line treatment for all newly presenting AFs?Anticoagulation/antiplatelet therapy + rate control
In AF with heart failure, what anticoagulant/antiplatelet should be used?Warfarin, alternatively dabigatran, rivaroxaban, apixaban or aspirin in low risk patients
For high risk patients in AF with heart failure, what is the INR target?2-3.5
For low risk patients in AF with heart failure, what is the INR target?2-3
In AF with heart failure, what should be used for rate control?Carvedilol and/or digoxin
What are general suggested goals for bpm in AF with heart failure?60-80bpm at rest, <115 bpm with exercise
What drug can often be used for rhythm control in AF?Amiodarone
What drug can often be used for pharmaceutical cardioversion in AF?Ibutilide
What can be used for rate control in AF?beta-blockers, diltiazem, verapamil, digoxin
What are the 3 elements in the management of chronic AF?Ventricular rate control, restoration and maintenance of sinus rhythm, prevention of thromboembolic events
What does the CHA2DS2-VASc score link to?%/year stroke risk
What should patients avoid after being diagnosed with AF?Triggering factors, such as caffeine or alcohol

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