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12 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Epidemiology of AF |
- affects 5-10% of people over the age of 65yrs |
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Common causes of AF |
- IHD - rheumatic heart disease - thyrotoxicosis - HTN |
4 |
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Cardiac causes of AF |
- HTN - CCF - CAD - MI - cardiomyopathy - valvular heart disease: including RF - WPW syndrome - myocarditis - pericarditis - sick sinus syndrome - cardiac surgery - genetic predisposition |
12 |
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Systemic causes of AF |
- thyrotoxicosis - phaechromocytoma - pulmonary disease: PE, pneumonia, COPD - symptathetic stimulation: exercise, adrenergic agents - parasympathetic stimulation: vagally-induced, post-prandial - alcohol - caffeine - smoking - recreational drugs - idiopathic |
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Types of AF |
- first detected
- paroxysmal - persistent - permanent |
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Symptoms of AF |
- asymptomatic - palpitations - dyspnoea - faintness |
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Signs of AF |
- irregularly irregular pulse - pulse deficit: difference between pulse & heart sound - sign of LVF |
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Rhythm control in AF |
Anticoagulate for 3wks before hand, unless AF has been present for < 2days - electrical: DC cardioversion - pharmacological: flacanide (no heart disease), amiodarone (heart disease) - other: catheter ablation of automaticity foci, Maze procedure, pacemaker |
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Rate control in AF |
Increase AV node refractoriness (used in older patients, or failure of rhythm control) - digoxin - beta blockers - Ca channel blockers: verapamil, diltiazem |
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Anticoagulation in AF
- target INR |
CHA2DS2-VASC score (CHF, HRN, Age >75yrs, DM, Stroke/TIA, vascular disease, Age 65-75yrs, Sex category e.g. female) of more than 2 - INR: 2-3 |
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Bleeding risk in AF |
HAS-BLED (HTN, Abnormal liver/renal fx, Stroke, Bleeding disorder/prior bleeding event, Labile INR, Elderly > 65yrs, Drug/alcohol use) score of > 3 signifies a high risk of bleeding, proceed with caution |
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DOACs - MOA |
- dabigatran: direct thrombin inhibitor - apixaban: factor Xa inhibitor - edoxaban: factor Xa inhibitor - riveroxaban: factor Xa inhibitor |
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