Week 8 - Stroke & Atrial Fibrillation || 100% Accurate Answers.
Atrial Fibrillation correct answers - Fibrillation occurs when the atrial cells cannot repolarize in
time for the next incoming stimulus.
- ECG shows grossly disorganized pattern of atrial electrical activity.
- Focus of ECG changes are in the P Wave, which is compatible with atrial depolarization.
- Absence of discernible P Wave.
- Presence of F Waves: fibrillatory waves of varying amplitude, duration and morphology.
- Consequentially, QRS complexes appear irregular in pattern as well.
Atrial Fibrillation - ECG changes correct answers - Absence of discernible P Wave.
- Presence of F Waves: fibrillatory waves of varying amplitude, duration and morphology.
- Consequentially, QRS complexes appear irregular in pattern as well.
Three types of Atrial Fibrillation correct answers 1. Paroxysmal: self-terminates, lasts less than 7
days
2. Persistent: lasts longer than 7 days, needs interventions such as cardioversion.
3. Permanent: doesn't respond to attempts of terminating it, and person remains in AFib.
Atrial rate during Atrial Fibrillation correct answers - 300-600 beats per minute
- Many impulses blocked at the AV Node.
Ventricular rate in Atrial Fibrillation correct answers - Completely irregular due to blocking at
the AV Node.
- 80-180 beats per minute if left untreated.
Pulse deficit correct answers - Difference between the apical rate and the palpable peripheral
pulse.
- Increases when ventricular rate is high.
- Happens because changes in stroke volume affect the capacity of the ventricular beats to
produce a pulse wave out to the periphery.
Atrial Fibrillation - Risk factors correct answers - Age: after 55, risk doubles with each decade
- Conditions that cause inflammation of the atrial tissue
a. Pericarditis
- Alcohol abuse
- Hyperthyroidism
- Conditions that cause enlargement of the heart:
a. Chronic high blood pressure
b. Valve disease
c. Lung disease
d. Heart failure
Incidence of Atrial Fibrillation correct answers - Most common heart arrhythmia
- 1% to 2% of the population
, Atrial Fibrillation - Signs and Symptoms correct answers - May not show any s&s.
- Severe symptoms can be felt usually at the onset of the arrhythmia.
- Palpitation
- Acute pulmonary edema
- Fatigue and other non-specific symptoms: common in older adults.
- Abnormal ECG: F waves instead of P waves.
Atrial Fibrillaiton - Treatments correct answers - Anticoagulant drugs: stroke prevention
- Persistent AFib: medications such as b-blockers, calcium channel blockers, etc.
- Cardioversion: considered when pulmonary edema or unstable cardiac status is present.
Atrial Fibrillation - How does increase risk of stroke? correct answers - AFib prevents the heart
from efficiently emptying with each beat.
- When blood doesn't completely empty from the atria, it can begin to pool.
- Pooled blood can clot, and blood clots that block entire blood vessels or arteries can cause a
stroke.
- Patients are put on blood thinners (anticoagulant medications) to prevent clotting.
Two types of Stroke correct answers 1. Ischemic
2. Hemorrhagic
Ischemic Stroke correct answers - Most common: 80%
- Interruption of blood flow to brain caused by a blood clot or other blockage in an artery.
- Clots can be:
a. thrombosis: clot formation - major arteries
b. emboli: artery occlusion - minor arteries
- Prevention: anticoagulants, anti-platelets.
- Treatment: tPA drugs (tissue Plasminogen Activator) - Alteplase
Ischemic Stroke - Major Causes correct answers - Thrombosis & Emboli (20%): large artery
atherosclerotic disease
- Lacunar (25%): small penetrating arteries.
- Cardiogenic embolism (20%): from thrombus in left heart
- Cryptogenic (30%): undetermined cause
- Other (5%): migraine, vessel dissection, coagulopathy
Ischemic Stroke - Modifiable Risk Factors correct answers - Hypertension
- Atherosclerosis
- Smoking
- Diabetes
- High cholesterol (LDL)
- Atrial Fibrillation
- Heart Attack (MI)
- Heart Failure
- Sickle cell disease (during sickle cell crisis)
- Polycythemia
Atrial Fibrillation correct answers - Fibrillation occurs when the atrial cells cannot repolarize in
time for the next incoming stimulus.
- ECG shows grossly disorganized pattern of atrial electrical activity.
- Focus of ECG changes are in the P Wave, which is compatible with atrial depolarization.
- Absence of discernible P Wave.
- Presence of F Waves: fibrillatory waves of varying amplitude, duration and morphology.
- Consequentially, QRS complexes appear irregular in pattern as well.
Atrial Fibrillation - ECG changes correct answers - Absence of discernible P Wave.
- Presence of F Waves: fibrillatory waves of varying amplitude, duration and morphology.
- Consequentially, QRS complexes appear irregular in pattern as well.
Three types of Atrial Fibrillation correct answers 1. Paroxysmal: self-terminates, lasts less than 7
days
2. Persistent: lasts longer than 7 days, needs interventions such as cardioversion.
3. Permanent: doesn't respond to attempts of terminating it, and person remains in AFib.
Atrial rate during Atrial Fibrillation correct answers - 300-600 beats per minute
- Many impulses blocked at the AV Node.
Ventricular rate in Atrial Fibrillation correct answers - Completely irregular due to blocking at
the AV Node.
- 80-180 beats per minute if left untreated.
Pulse deficit correct answers - Difference between the apical rate and the palpable peripheral
pulse.
- Increases when ventricular rate is high.
- Happens because changes in stroke volume affect the capacity of the ventricular beats to
produce a pulse wave out to the periphery.
Atrial Fibrillation - Risk factors correct answers - Age: after 55, risk doubles with each decade
- Conditions that cause inflammation of the atrial tissue
a. Pericarditis
- Alcohol abuse
- Hyperthyroidism
- Conditions that cause enlargement of the heart:
a. Chronic high blood pressure
b. Valve disease
c. Lung disease
d. Heart failure
Incidence of Atrial Fibrillation correct answers - Most common heart arrhythmia
- 1% to 2% of the population
, Atrial Fibrillation - Signs and Symptoms correct answers - May not show any s&s.
- Severe symptoms can be felt usually at the onset of the arrhythmia.
- Palpitation
- Acute pulmonary edema
- Fatigue and other non-specific symptoms: common in older adults.
- Abnormal ECG: F waves instead of P waves.
Atrial Fibrillaiton - Treatments correct answers - Anticoagulant drugs: stroke prevention
- Persistent AFib: medications such as b-blockers, calcium channel blockers, etc.
- Cardioversion: considered when pulmonary edema or unstable cardiac status is present.
Atrial Fibrillation - How does increase risk of stroke? correct answers - AFib prevents the heart
from efficiently emptying with each beat.
- When blood doesn't completely empty from the atria, it can begin to pool.
- Pooled blood can clot, and blood clots that block entire blood vessels or arteries can cause a
stroke.
- Patients are put on blood thinners (anticoagulant medications) to prevent clotting.
Two types of Stroke correct answers 1. Ischemic
2. Hemorrhagic
Ischemic Stroke correct answers - Most common: 80%
- Interruption of blood flow to brain caused by a blood clot or other blockage in an artery.
- Clots can be:
a. thrombosis: clot formation - major arteries
b. emboli: artery occlusion - minor arteries
- Prevention: anticoagulants, anti-platelets.
- Treatment: tPA drugs (tissue Plasminogen Activator) - Alteplase
Ischemic Stroke - Major Causes correct answers - Thrombosis & Emboli (20%): large artery
atherosclerotic disease
- Lacunar (25%): small penetrating arteries.
- Cardiogenic embolism (20%): from thrombus in left heart
- Cryptogenic (30%): undetermined cause
- Other (5%): migraine, vessel dissection, coagulopathy
Ischemic Stroke - Modifiable Risk Factors correct answers - Hypertension
- Atherosclerosis
- Smoking
- Diabetes
- High cholesterol (LDL)
- Atrial Fibrillation
- Heart Attack (MI)
- Heart Failure
- Sickle cell disease (during sickle cell crisis)
- Polycythemia
