Atrial Fibrillation_fall 2012


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Unformatted text preview: +, Mg2+, Ca2+ Lone AF – Occurs in absence of heart disease – Usually applies to patients < 60 years Hemodynamic Consequences Hemodynamic Consequences Rapid, irregular heart rate – Hypotension, angina, syncope Loss of atrial kick → ↓ stroke volume (SV) and cardiac output (CO) ↓ ventricular diastolic filling time → ↓ SV and CO Tachycardia­induced cardiomyopathy Thromboembolic Consequences Thromboembolic Consequences Loss of organized mechanical contraction in atrial → Pooling of blood in atria → Mural thrombi – Thrombi can break off andtravel up carotid artery to brain → Thromboembolic stroke – Does not cause DVT or PE AF is responsible for up to 20% of all strokes Stroke Risk Stratification Stroke Risk Stratification CHADS2 index: – Each letter represents a significant risk factor for stroke in patients with AF: Congestive heart failure HTN Age (>75 yr) Diabetes Stroke or transient ischemic attack (TIA) Stroke Risk Stratification Stroke Risk Stratification Patients are assigned a score for each of these risk factors – 1 point Congestive heart failure,...
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