Now with atrial fibrillation, what is the
patient feeling? It could be 300 beats per
minute. Wow, palpitations, irregular heart
rate. Is that clear? So an EKG you will not
have a regular rhythm at all. Fatigue, angina,
dyspnea, lightheadedness, syncope. What is
going on with all those, please? Decreased
cardiac output. You lose the proper ability
of kicking blood into left ventricle so that
you can supply oxygen to the tissues. Angina,
sure, why not? Once again. You have increased
the work, haven't you? So maybe you can't keep
up with the demand for oxygen of the heart
resulting in angina and chest pain. So now
you are seeing that as we go through medicine
here really pathology is medicine. I mean
just it comes under an umbrella, but it is
really you being able to come up with differentials
based on the fact that well your patient is
feeling chest pain, but that could be so many
different things. So you read the rest of the
story. You ask the patient the right questions
so that you can arrive at the proper diagnosis.
You start doing that now, you will never go
wrong. Atrial fibrillation.
Remember all of this
is part of SVT. What does that mean to you?
What is your objective? Clinically, medically.
You want to prevent this arrhythmia or
any type of arrhythmia from going into the
ventricles, why? Because once you hit the
ventricles, my goodness then you cause complete
disorganisation of ventricular rhythm. You
may then compromise cardiac output. It may
result in ventricular fibrillation and death.
You don't want that. Important causes include
hypertensive heart disease. Hypertension, 140/90.
Our comment is that in the US or really in
the world, extremely common as we get older,
atrial fibrillation, ischemic heart disease
once again coronary artery disease, atherosclerosis
extremely common. Hyperthyroidism, endocrinology
extremely common. Alcohol, pulmonary embolus.
Take a look at these. These are important
differentials or etiologies, which occur quite
commonly. Therefore atrial fibrillation is
quite common. And so therefore, you really want
to pay attention to that clot formation perhaps
in the left atrium more commonly in you
the left atrium.