Atrial Contraction Case Study

Due to this irregularity in the beating of the heart in patients with atrial fibrillation, the flow of blood is affected. This can cause blood cells to stick together and increases the risk of a blood clot forming in the upper chambers of the heart (the atria). In people with atrial fibrillation, the most common place for these blood clots travel to is the brain and this can result in a strike. The bigger the clot and the larger the blocked artery is, the more devastating the consequences of the strike can be. If very small clots are dislodged from the main clot in the heart, a mini-stroke (called a ‘transient ischemic attack’ or TIA) could occur but the symptoms resolve within a day. It is rare for patients with atrial fibrillation to develop symptoms from blockages in other arteries, for example a blockage in the arteries in the heart, resulting in a heart attack. This is because the brain is affected much more by the loss of its blood supply caused by a blood clot and the brain produces symptoms when smaller blood vessels are blocked. In addition, there is a large flow of blood to the brain so clots emerging from the heart are more likely to be directed into the brain than

For decades, Warfarin has remained the anticoagulant of choice for the prevention of cardiac thromboembolic disease in atrial fibrillation patients and in the treatment of deep vein thrombosis and pulmonary embolism. VKAs are clinically effective as an antithrombotic agent in Atrial Fibrillation, as dose adjusted warfarin has been proven to cut the risk of stroke by 64% (95% CI, 49%-74%) and all-cause death rate by 26% (95% CI, 3%-43%) [2]. In order to attain optimal anticoagulation effect of warfarin, frequent plasma level monitoring of International Normalized Ratio (INR) is required to maintain it in therapeutic range (INR 2-3) but maintaining the INR in therapeutic range is challenging and for many patients is achieved only approximately 55% of the time [3]. Thus, this finding counteracts the potential benefits of warfarin and increases its risks. A combination of factors like an inconvenience for patients and clinicians to use warfarin, large variability in plasma level of the drug affected by ethnicity and genetic polymorphism [4,5], interactions with various foods and drugs and the potential for serious hemorrhage e.g. Intracranial bleeding, have limited the widespread use of warfarin as an effective anticoagulant in nonvalvular atrial fibrillation (NVAF) [6]. Keeping in mind these facts about

Atrial fibrillation is one type of arrhymia, often rapid heart rate. Atrial fibrillation mean the atrial contract to quicky, disturbance between the atrial and the ventrical. AF usually isn’t life- threatening, however this is dangerous because the patient may not have symptoms, but it can increase risk of heart failure and stroke because the blood flow isn’t fluent.

My father is an atrial fibrillation patient and had a surgery for it in February but a clot was found in his heart before the surgery, so his surgery was being delayed. He was given blood thinners and medications to remove the clot. I was very scared at that time because I was being told that this clot could also cause a brain stroke. My mother had a spinal surgery in 2014 and has problems with mobility. She also gets injections in her eyes due to diabetes. My parents are dependent on me for all their household jobs and their hospital/GP appointments. I tried to manage my family circumstances with studies but I have failed. My dad had a stone in gall bladder and a bag was connected to him for bile drainage. He could not go through his gall

According to a new study found that people with abnormal heart rhythm called atrial fibrillation that commonly used painkillers can increase the risk of bleeding and blood clots.This risk is even higher among those who are taking blood thinners with pain medications, such as anti-inflammatory drugs, which is not Dr. Nath Islamic Guinea (Gunnar Gislason) said that if you add NSAIDs on blood thinners, you have double the risk of bleeding.He noted that people with atrial fibrillation taking blood thinners to reduce the risk of ischemic stroke. Atrial fibrillation causes the upper recording rapid heart contractions and irregular. Twisted contract will form a blood clot, which can lead to ischemic stroke if it's from the heart and go to the brain.Dr.

Azoulay, Dell’Aniello, Simon, Renoux, and Suissa (2013) performed a post-hoc nested-control analysis using the United Kingdom’s clinical practice research datalink database of 70,766 patients aged 18 years and older, who were diagnosed with atrial fibrillation between 1993 and 2008. Patients with less than one year of medical history in the database, as well as patients with a history of mitral or aortic valve repair or replacement, or patients with a history of hyperthyroidism were excluded from the study. By using conditional logistic regression, Azoulay et al. (2013) was able to determine that there was a 71% increase of stroke during the first 30 days of warfarin treatment, with a decreased risk after the first 30 days. Azoulay et al. (2013) goes on to conclude that warfarin-naïve patients (patients who have never taken warfarin previously) with atrial fibrillation might have a greater increased risk for thrombotic events during the first 30 days of warfarin initiation. Therefore, the study concluded that the increased clotting risk may be due to a warfarin induced hypercoaguable state, or it may be due to the extended time interval it takes for a therapeutic INR to be achieved by inexperienced warfarin

The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

It's known that atrial fibrillation (AF) is the most common sustained cardiac arrhythmia representing abnormal rapid and irregular ventricular rates with deterioration of atrial mechanical function resulted by disorganized atrial electrical activity classified as acute, chronic, paroxysmal, intermittent, constant, persistent, or permanent and when a patient has 2 or more episodes, AF is considered recurrent(1). During the last decade, it accounted for approximately one third of hospital admissions for cardiac arrhythmias with progressive increases in the worldwide prevalence and incidence(1,2). It is more common in patients with cardiovascular problems such as hypertension, valvular heart disease, congestive heart failure (CHF) or coronary

The management of Warfarin is complicated because of its intricate pharmacokinetic and pharmacodynamic properties and narrow therapeutic range. Having optimal outcomes as a result of Warfarin therapy depends on maintaining the INR (International Normalized Ratio) in its range. In order to do so, high-quality anticoagulation management (HQACM) is required. HQACM involves reaching efficacy through acts such as appropriate therapy initiation, maintenance of therapeutic anticoagulation measured through TTR, monitoring anticoagulation at the appropriate frequency, managing peri-operative dosing and managing nontherapeutic INRs, as well as measuring safety through bleeding management, patient education and extensive communication. The goals of Warfarin management include obtaining the highest efficacy to prevent thromboembolism and minimizing risk to prevent bleeding. The most known method used for calculating the therapeutic effectiveness of Warfarin over a period of time is TTR. There are many factors such as medications, diet, and concomitant disease states that can alter the pharmacokinetics of Warfarin, therefore,

A total of 3,425 (87%) and 5,301 (90%) patients were taking low-dose rivaroxaban (10 to 15 mg once daily) and dabigatran (110 mg twice daily), respectively. Compared with warfarin, both rivaroxaban and dabigatran significantly decreased the risk for ischemic stroke or systemic embolism (p = 0.0004 and p = 0.0006, respectively), intracranial hemorrhage (p = 0.0007 and p = 0.0005, respectively), and all-cause mortality (p < 0.0001 and p < 0.0001, respectively) during the short follow-up period. In comparing the 2 non-vitamin K antagonist oral anticoagulant agents with each other, no differences were found regarding risk for ischemic stroke or systemic embolism, intracranial hemorrhage, myocardial infarction, or mortality. Rivaroxaban carried

Atrial Fibrillation, a heart condition that causes irregular beating, can result in blood clots. A possible treatment seemed to be through anticoagulation, which would thin the blood and decrease the likelihood of blood clots. “Bad medicine: Atrial fibrillation”, published in the British Medical Journal, discusses how medicine can become reactive rather than proactive as it states, “if the anticoagulation numbers are wrong then we risk the slow growing of a perfect storm of overtreatment, iatrogenic harm, and bad medicine”(Spence). A serious risk factor for taking an anticoagulant would be difficulty stopping and slowing down bleeding. Minor injuries such as falls or cuts could be deadly to a patient on an anticoagulant. Losses of lives, such as David Barker’s, could have been prevented if the approach to treatment would have focused on fixing the irregular beating rather than chance of blood clots, which only tries to alleviate a side effect of the condition. Through Popper’s perspective on the elements of precise support of theories and Butler’s ideas on how to improve research, we can understand why

FDA (2014) conducted its own observational study of 134,000 Medicare beneficiaries ages 65 and older, comparing dabigatran and warfarin for rates of ischemic stroke, intracranial hemorrhage, major gastrointestinal bleeding, myocardial infarction, and death. They found that dabigatran was associated with a lower risk of ischemic stroke, intracranial hemorrhage, and death compared with warfarin. They observed an increased risk of major gastrointestinal bleeding compared to warfarin. These findings echo those of the RE-LY trial. Based on this data, the FDA did not adjust dabigatran’s label or recommendations for use, but advises health care professionals and patients to report adverse side effects to the FDA MedWatch program (U.S. FDA,

As the most common cardiac arrhythmia, atrial fibrillation (AF) significantly increases the risk of ischemic stroke.(1) Anticoagulation is an important management approach to lower the risk of thromboembolism in AF.(2) Warfarin has been the mainstay of oral therapy to prevent stroke in AF patients for over 60 years.(3) A meta-analysis of nonvalvular atrial fibrillation shows that warfarin has a 64% reduction in the relative risks of stroke and 26% for all-cause mortality.(4) Owing to the need for systematic monitoring for international normalized ratio (INR) and the risk of various types of bleeding, warfarin is underutilized.(5) Patients who receive warfarin only spend 63.6% of the treatment time in the therapeutic range.(6)

Anticoagulant and Anti Thrombolytic – It is used for Atrial Fibrillation (AF). It helps to prevent the ischemic stroke in AF patients (Shakib, 2010). While monitoring the sign and symptoms of hemorrhage and as well as INR and PT, Mrs. Audrey is more likely to commence a low molecular weight heparin. As such, empirical studies suggest that the rate of the venous thromboembolism is lowered with patient on heparin than those managed with warfarin (Colwell et al., 1999).

Atrial Fibrillation (AF) known to be the common category of cardiac arrhythmias. It is mainly due to the rate or rhythm abnormalities of the heart and is a type of ‘supraventricular tachycardia’ (SVT). Rapid and irregular heart beating is a characteristic sign of atrial fibrillation. It is of significance since it a high risk of leading to thromboembolic events, heart failure and mortality (1).