Atrial Fibrillation Case Study

- The goals of treatment include a decrease in ventricular response (to less than 100 beats/minute), prevention of stroke, and conversion to normal sinus rhythm, if possible. To accomplish this, I would expect the health care provider to initially order drugs to control the ventricular rate, such as calcium channel blockers, beta-adrenergic blockers, digoxin, and dronedarone. For some patients, pharmacologic or electrical conversion of the atrial fibrillation to normal sinus rhythm may then also be considered, such as by using amiodarone or electrical cardioversion. If the atrial fibrillation lasts for longer than 48 hours, anticoagulation therapy will be needed for 3-4 weeks before the cardioversion and for weeks after as well. If drugs or cardioversion do not work, radiofrequency catheter ablation and the Maze procedure would be expected as further options.

The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the

Most physicians and people who acquired the problem usually know it as A-FIB, a shorter term for atrial fibrillation. Atrial fibrillation deals with the cardiovascular system, in particular, the heart in the body. It is defined as, “the electrical signals that control this system are off-kilter. Instead of working together the atria do their own thing, causing fast fluttering heartbeat, also known as arrhythmia” (WEBMD). In a normal pumping blood of the heart the atria would squeeze first, followed by the ventricles of the heart. A-fib can be a serious issue if not treated, due to the inadequate pumping of the blood, causing a higher chance of heart failure. It is also a higher chance in getting a stroke, because improper flow of the blood can cause clots in the

African American male that is seen today for followup post hospital discharge. He is a 48-year-old gentleman with complicated cardiac history as well as neurological history including congestive heart failure. History of strokes 01/2017, possible sick sinus syndrome. He has an implanted pacemaker that was placed in 06/2017, as well as hypertension. He was taken to the Central Hospital on 09/01 with presentation of chest pain, noted to be around his pacemaker site. He identified being in seizure and suddenly felt chest pain with shortness of breath, and was offered nitro, he developed headaches and dyspnea post nitro treatment, of note is that the EKG that was obtained during that process, did not identify any pacemaker spike despite having a

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P

The overall view of the article discusses the effectiveness of medication administration during the out-of-hospital cardiac arrest. A study performed out of Oslo, Norway performed a study of cardiac arrest patient and the outcomes based on that patient receiving medications outlined in the ACLS guidelines and patient who received only mechanical resuscitation efforts. The service used covers a population of approximately 500,000 people and each ambulance is staffed with two paramedics. In the event of a cardiac

Today millions of Americans live or have lived with Atrial fibrillation. The main concern with this health issue is that many people who lived with it sometimes are not aware of it. Atrial fibrillation is defined by Mayo Clinic (2012) as “an irregular and often rapid heart rate that commonly causes poor blood flow to the body”. It occurs when the four chambers of the heart have a disrupted rhythm. The abnormal functionality of health may lead to a stroke because of the possible blood clot that will be formed. The Atrial fibrillation or Afib put the body in a situation without oxygen and nutrients because the body is not well supplied by a heart that is became weak. In general, only few people will feel change in their heartbeat. They may verbalize

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

Atrial fibrillation - a common heart rhythm disorder in which the upper chambers of the heart beat rapidly and chaotically. Atrial fibrillation can be caused by heart abnormality from birth, or damage to the heart structure from a heart attack or heart valve problem. However, people with normal hearts may also develop atrial fibrillation. Sometimes people with this condition can have slow rhythms. Medicines used to control atrial fibrillation may result

The heart is one of the most important organs in an organism’s body, no matter if they are aquatic, amphibian, or a mammal. This super organ works automatically, able to pump massive amounts of oxygen rich blood through the body by means of electrical impulses and the opening and closing of valves within its many layers. It is what keeps us and every other creature on this earth alive; so it is only natural for one to fear when there might be a problem with one’s heart. A cardiac arrhythmia can happen to anyone, no matter the age, race, or gender, and as such, doctors and scientist have spent years trying to better understand the heart and the way it functions so that they can try to prevent these problems and save millions of lives.

Melvin Rodriguez was admitted at the intensive care unit. On the first hospital day, he developed hypotension, BP of 70/40, cardiac rate of 100 beats per minute, rales all over lung fields, respiratory rate of 24 breaths per minute. Pertinent physical examination showed patient was dyspneic, distented neck vein. Patient was on left ventricular failure with pulmonary congestion.

A female patient at the mature age of 78 was presented to A&E with symptoms in accordance with new onset Atrial Fibrillation(AF). The patients’ medical history was notable only for controlled hypertension, which recurrently coexists with AF and is acknowledged for being one of the principal risk factors of AF. With Hypertension being ‘… the most common cardiovascular disorder’ and AF equally being ‘… the most common clinically significant sustained cardiac arrhythmia’, the management routes must be cautiously considered so the appropriate treatment care can be administered for the patient (Manolis et al, 2012).

The low mortality rate observed in patients without heart disease, even in the absence of an effective therapy, makes it difficult to demonstrate any variation in the prognosis. The basic objective in these patients is to improve symptoms and quality of life, to avoid the adverse effects of antiarrhythmic agents and to cure the arrhythmia in order to prevent the development of atrial dilation, need for anticoagulant therapy and increased risk. In population-based studies, as the Framingham study, the presence of AF increased long-term mortality 1.5 to 1.9 times.