Atrial Fibrilation Flashcards Preview

OSCE Conditions > Atrial Fibrilation > Flashcards

Flashcards in Atrial Fibrilation Deck (11):
1

Symptoms of AF

Asymptomatic
Palpitations
Dyspnoea
Fatigue
Dizziness
Angina
Syncope

2

Signs of AF

Pulse is irregularly irregular
Tachycardia
Raised JVP
S3 heart sound

3

Pathophysiology of AF

Disorganised contraction of the atria (rapid irregular twitching)
Possibly due to multiple small reentry loops in the atria

4

Investigations of AF

ECG would show absent P-waves, tachycardia, irregularly irregular rhythm

5

Management of AF

Give:
Warfarin (stroke prevention)
Flecainide (rhythm control)
B-blocker/digoxin (rate control)

Lifestyle advice - reduce CVS risk factors

6

Mechanism of action of warfarin

Inhibits production of Vitamin K dependent clotting factors (2,7,9,10) by inhibiting the reduction of Vit K back to its active form

7

ADRs and DDIs of warfarin

ADRs: haemorrhagic eg. GI bleed/epistaxis/intracranial/excessive bruising, teratogenic in 1st trimester

DDIs: CYP450 inducers inhibit warfarin, inhibitors potentiate effects of warfarin. Aspirin, cephalosporin antibiotics and NSAIDs also potentiate effects

8

Mechanism of action of flecainide

Na channel blocker, reduces rate of depolarisation in the AP, so prevents premature beats

9

ADRs and contraindications of flecainide

ADRs: proarrhythmic, drowsiness, dizziness, GI disturbance
Contraindications: IHD, structural heart defects

10

Causes of AF

Idiopathic
Ischaemic heart disease
Thyroid disease
Hypertension
MI
PE
Valve disease (mitral/tricuspid)
LV dysfunction
Alcohol

11

AF differential diagnosis

Atrial flutter
Wolf-Parkinson-White syndrome
Atrial tachycardia