Episode 20: Atrial Fibrillation
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Feb 10, 2012 Dr. Nazanin Meshkat, an emergency physician at University Health Network, Dr. Clare Atzema from Sunnybrook Health Sciences, and Dr. Bryan Au from St. Michael’s Hospital delve into the complexities of Atrial Fibrillation. They discuss the critical balance between rate and rhythm control and the nuances of anticoagulation strategies, particularly using the CHADS-VASc score. The guests also highlight the risks associated with Wolff-Parkinson-White syndrome in AFib and share insights on managing patients with varying histories and conditions.
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Key History Questions for AFib
- Ask AFib patients about the onset time, past treatments, and cardiac history.
- Inquire about anticoagulation, meds, recent ECG, and CHADS2 score.
AFib Causes and Lone AFib
- Consider ACS, PE, myocarditis, and hyperthyroidism as potential AFib causes.
- Lone AFib, affecting younger patients without cardiac disease, has a different prognosis.
AFib Differentials and Sleep Apnea
- Remember the PIRATES mnemonic for AFib differentials: Pulmonary embolism, Ischemia, Respiratory disease, Atrial issues, Thyroid, Ethanol, Sepsis.
- Consider sleep apnea, present in up to 50% of AFib patients, as a treatable cause.