Atrial Fibrillation || 100% Correct Solutions.
What are common contributing factors to atrial fibrillation? correct answers - increasing age
- underlying cardiopulmonary disease (ex. HTN, heart failure, valvular disease, and COPD)
- hyperthyroidism
- sepsis
- pulmonary embolism
- electrolyte abnormalities
What are early complications of AFib? correct answers - diminished cardiac output
- hypotension
What are late complications of AFib? correct answers - thromboembolism
- cardiomyopathy
True or false:
AFib rarely exists in isolation, and is typically a manifestation of other underlying disease
processes. correct answers True
A patient is brought to the ED because of dyspnea and palpitations. What should the initial
approach be? correct answers - ABCs (airway, breathing, circulation)
- assessment of any life-threatening concerns
- upon arrival, the pt should get an IV and be placed on cardiac and pulse oximetry monitors.
- The hx and PE should focus on the pt's cardiac and pulmonary status.
- If the pt's pulse and rhythm on the cardiac monitor reveals irregular tachycardia, an immediate
EKG should be obtained.
In a pt with symptomatic AFib and rapid ventricular response, what is early priority
management? correct answers Slow the ventricular rate
For pts with symptoms of AFib, the typical sx of palpitations and dyspnea can be alleviated
through what? correct answers rate control
In rare cases, tachycardia and the loss of the "atrial kick" can lead to what 3 things? correct
answers - diminished cardiac output
- hypotension
- CHF
If the pt is experiencing diminished cardiac output, hypotension, or CHF, and the arrhythmia is
thought to be the primary cause of the patient's instability, what is indicated? correct answers
Emergent electrical cardioversion
In more stable patients, the decision of whether to convert the rhythm depends on a number of
which factors? correct answers - risk of thromboembolism
- need for anticoagulation
- odds of recurrent AFib
,In all patients with AFib, why should a search for the underlying etiology be undertaken? correct
answers Because AFib is often best managed by treating the underlying cause of the rhythm,
rather than the rhythm itself.
Name cardiac diseases associated with AFib. correct answers - HTN (approx 80% of cases)
- CAD
- Cardiomyopathy
- Valvular heart disease
- Rheumatic heart disease
- Congential heart disease
- MI
- Pericarditis
- Myocarditis
Name pulmonary diseases associated with AFib. correct answers - pulmonary embolism
- COPD
- obstructive sleep apnea
Name systemic diseases associated with AFib. correct answers - hyperthyroidism
- obesity
- diabetes
- metabolic syndrome
- inflammation
Name postoperative causes associated with AFib. correct answers - cardiac surgery
- any surgery
Can binge alcohol drinking contribute to AFib? correct answers Yes, referred to as "holiday heart
syndrome."
Lone AFib is associated with how many cases (no other obvious underlying etiology?) correct
answers Associated with 10% of AFib cases
Define lone AFib. correct answers A term used to describe AFib in patients younger than 60
years old, who have no obvious underlying cardiopulmonary disease process.
Define dyspnea. correct answers Difficult or labored breathing, shortness of breath, or a
sensation of breathlessness.
Define thromboembolism. correct answers The passage of a blood clot through the vascular
system from one part of the body to another.
For example, in the setting of AFib: a clot forms in the heart, and then embolizes through the
arterial circulation to the brain, mesentery, or extremities.
, Define cardiomyopathy. correct answers Damage to heart muscle as the result of a number of
various insults, causing diminished contractility.
This can eventually lead to heart failure, arrhythmia, and sudden death.
AFib affects what percent of the general population? correct answers 1%
What is the most common, treatable, arrhythmia seen in the emergency dept? correct answers
Atrial Fibrillation
True or false:
AFib prevalence increases with age. correct answers True
In adults younger than 55, the prevalence is 0.1%.
In adults greater than 80 years old, the prevalence is greater than 10%.
Is AFib more common in men or women? correct answers More common in men
Also more common in whites than blacks
Among pts with AFib, 80% of patients have what kind of disease? correct answers
Cardiovascular disease
MC: HTN, CAD, valvular heart disease, and cardiomyopathy.
What is the physiology of AFib? correct answers It is theorized that AFib is caused by a complex
interaction between triggers for AF and abnormal atrial myocardium that has multiple reentrant
circuits or automatic foci outside the sinoatrial (SA) node.
This interplay leads to rapid electrical activity in the atria, which can supersede the SA node and
produce the disorganized and ineffective atrial contractions typical of AFib.
The rapid atrial electrical activity is also conducted through the atrioventricular (AV) node,
leading to an irregular ventricular response.
How does AFib look on EKG? correct answers AFib looks like an irregularly irregular, usually
narrow complex, tachycardia, without associated P-waves.
AFib has a number of clinical implications, most importantly which 2? correct answers -
cardiomyopathy
- thromboembolism
Acutely, the loss of the "atrial kick" leads to a reduction in cardiac output by as much as what
percent? correct answers 15%
What are common contributing factors to atrial fibrillation? correct answers - increasing age
- underlying cardiopulmonary disease (ex. HTN, heart failure, valvular disease, and COPD)
- hyperthyroidism
- sepsis
- pulmonary embolism
- electrolyte abnormalities
What are early complications of AFib? correct answers - diminished cardiac output
- hypotension
What are late complications of AFib? correct answers - thromboembolism
- cardiomyopathy
True or false:
AFib rarely exists in isolation, and is typically a manifestation of other underlying disease
processes. correct answers True
A patient is brought to the ED because of dyspnea and palpitations. What should the initial
approach be? correct answers - ABCs (airway, breathing, circulation)
- assessment of any life-threatening concerns
- upon arrival, the pt should get an IV and be placed on cardiac and pulse oximetry monitors.
- The hx and PE should focus on the pt's cardiac and pulmonary status.
- If the pt's pulse and rhythm on the cardiac monitor reveals irregular tachycardia, an immediate
EKG should be obtained.
In a pt with symptomatic AFib and rapid ventricular response, what is early priority
management? correct answers Slow the ventricular rate
For pts with symptoms of AFib, the typical sx of palpitations and dyspnea can be alleviated
through what? correct answers rate control
In rare cases, tachycardia and the loss of the "atrial kick" can lead to what 3 things? correct
answers - diminished cardiac output
- hypotension
- CHF
If the pt is experiencing diminished cardiac output, hypotension, or CHF, and the arrhythmia is
thought to be the primary cause of the patient's instability, what is indicated? correct answers
Emergent electrical cardioversion
In more stable patients, the decision of whether to convert the rhythm depends on a number of
which factors? correct answers - risk of thromboembolism
- need for anticoagulation
- odds of recurrent AFib
,In all patients with AFib, why should a search for the underlying etiology be undertaken? correct
answers Because AFib is often best managed by treating the underlying cause of the rhythm,
rather than the rhythm itself.
Name cardiac diseases associated with AFib. correct answers - HTN (approx 80% of cases)
- CAD
- Cardiomyopathy
- Valvular heart disease
- Rheumatic heart disease
- Congential heart disease
- MI
- Pericarditis
- Myocarditis
Name pulmonary diseases associated with AFib. correct answers - pulmonary embolism
- COPD
- obstructive sleep apnea
Name systemic diseases associated with AFib. correct answers - hyperthyroidism
- obesity
- diabetes
- metabolic syndrome
- inflammation
Name postoperative causes associated with AFib. correct answers - cardiac surgery
- any surgery
Can binge alcohol drinking contribute to AFib? correct answers Yes, referred to as "holiday heart
syndrome."
Lone AFib is associated with how many cases (no other obvious underlying etiology?) correct
answers Associated with 10% of AFib cases
Define lone AFib. correct answers A term used to describe AFib in patients younger than 60
years old, who have no obvious underlying cardiopulmonary disease process.
Define dyspnea. correct answers Difficult or labored breathing, shortness of breath, or a
sensation of breathlessness.
Define thromboembolism. correct answers The passage of a blood clot through the vascular
system from one part of the body to another.
For example, in the setting of AFib: a clot forms in the heart, and then embolizes through the
arterial circulation to the brain, mesentery, or extremities.
, Define cardiomyopathy. correct answers Damage to heart muscle as the result of a number of
various insults, causing diminished contractility.
This can eventually lead to heart failure, arrhythmia, and sudden death.
AFib affects what percent of the general population? correct answers 1%
What is the most common, treatable, arrhythmia seen in the emergency dept? correct answers
Atrial Fibrillation
True or false:
AFib prevalence increases with age. correct answers True
In adults younger than 55, the prevalence is 0.1%.
In adults greater than 80 years old, the prevalence is greater than 10%.
Is AFib more common in men or women? correct answers More common in men
Also more common in whites than blacks
Among pts with AFib, 80% of patients have what kind of disease? correct answers
Cardiovascular disease
MC: HTN, CAD, valvular heart disease, and cardiomyopathy.
What is the physiology of AFib? correct answers It is theorized that AFib is caused by a complex
interaction between triggers for AF and abnormal atrial myocardium that has multiple reentrant
circuits or automatic foci outside the sinoatrial (SA) node.
This interplay leads to rapid electrical activity in the atria, which can supersede the SA node and
produce the disorganized and ineffective atrial contractions typical of AFib.
The rapid atrial electrical activity is also conducted through the atrioventricular (AV) node,
leading to an irregular ventricular response.
How does AFib look on EKG? correct answers AFib looks like an irregularly irregular, usually
narrow complex, tachycardia, without associated P-waves.
AFib has a number of clinical implications, most importantly which 2? correct answers -
cardiomyopathy
- thromboembolism
Acutely, the loss of the "atrial kick" leads to a reduction in cardiac output by as much as what
percent? correct answers 15%
