A Simple Guide to Atrial Fibrillation I

A Simple Guide to Atrial Fibrillation I
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What is Atrial Fibrillation?
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Atrial Fibrillation is a heart condition where the disordered electrical impulses of the atrial muscle leads to irregular electrical impulses to the ventricular heart muscles resulting in irregular heart beats.


Who is at risk of Atrial Fibrillation?
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1.Age: 8% of people over 80 has AF

2.family history of AF increases risk by 30%.

What is the cause of Atrial Fibrillation?
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Atrial Fibrillation is caused by underlying heart conditions such as:

1.Primary heart diseases:

a.coronary artery disease

b.mitral stenosis

c.mitral regurgitation

d.hypertrophic cardiomyopathy

e.pericarditis

f.congenital heart disease

g.previous heart surgery

2.Hypertension (High blood pressure)

3.Lung diseases such as

a.pneumonia,

b.lung cancer,

c.pulmonary embolism,

d.sarcoidosis

4.Excessive alcohol consumption

5.Hyperthyroidism


What are the Symptoms of Atrial Fibrillation?
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Atrial fibrillation often do not present with symptoms.

When they do the symptoms are generally non -life threatening:

Symptoms:
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1.fast heartbeat or palpitations

2.Breathlessness

3.fainting

4.chest pain

Signs:
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1.Pulse is fast and irregular in rhythm and strength

2.Angina pectoris(pain over heart area)

3.Congestive cardiac failure with ankle swelling and breathlessness

4.exercise intolerance

5.Abnormal ECG reading with absent P waves and irregular rhythm

6.Underlying heart disease such as hypertension, pericarditis, valvular disease of heart,

7.Underlying systemic disease such as hyperthyroidism, diabetes, stroke


How is diagnosis of Atrial Fibrillation made?
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1. History and physical examination

Palpitations, atrial fibrillation episodes

2. Blood tests:

renal function and electrolytes,
thyroid hormones, thyroid-stimulating hormone,
blood count.

Where there is chest pain,

blood cardiac enzymes and
coagulation tests are also done

3.Electrocardiogram

a.absence of P waves,
b.irregularity of R-R interval due to irregular conduction of impulses

4.Echocardiography

transthoracic echocardiogram is done in newly diagnosed AF to detect

valvular heart disease ,
left and right atrial size,
left ventricular size and function,
peak right ventricular pressure ,
presence of left ventricular hypertrophy
pericardial disease

5. Chest X-ray

chest X-ray is generally only performed if a pulmonary cause of atrial fibrillation is suggested,

6.Transesophageal echocardiogram

transesophageal echocardiogram (TEE) is done to detect thrombus formation

7.Ambulatory holter monitoring

A holter monitor is a heart monitor which can be worn by the patient to check the heart rate and heart rhythm for 24 hours.

It can detect presence of AF.

8.Exercise stress testing

A threadmill test can gauge the heart rate in response to exertion.