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Atrial Fibrillation Overview

Symptoms:
Palpitations, light-headedness, dizziness, dyspnea, exercise intolerance, chest pain, near-syncope, syncope.

1. Why?
Cardiac:
• Valvular heart disease
•
Atrial Fibrillation ... Decompensated HF • New ischemia ... Noncardiac: • Pulmonary ... Cardiology #Management ... #Algorithm
Atrial Fibrillation - Diagnosis, Causes, Presentations
Causes (PIRATES):
 - Pulmonary embolism 
 - Ischemia (cardiac) 
 -
Atrial Fibrillation ... (PIRATES): - Pulmonary ... embolism - Ischemia ... #Fibrillation # ... PIRATES #Emergency #Cardiology
Non-lschemic Causes of Cardiogenic Shock:

Beta-Blockers, Calcium Channel Blockers, Digoxin 

Myocarditis 

Cardiomyopathies (sarcoidosis, amyloidosis, Takatsubo, 
hemochromatosis) 

Valvular
Non-lschemic Causes ... Supraventricular/Atrial ... Ventricular Fibrillation ... Tamponade, pulmonary ... Differential #Diagnosis #Cardiology
Causes of Ischemic Stroke - Differential Diagnosis Algorithm
Thrombosis - Atherosclerosis, Arterial Dissection, Fibromuscular Dysplasia
 - Large
Causes of Ischemic ... Valvular • Atrial ... fibrillation ... infarction • Pulmonary ... effusion • Shock
Heart Failure with Preserved Ejection Fraction: Management Principles

General Therapeutic Principles:
Reduce the congestive state 
 - Caution
fibrilation may ... prevent myocardial ischemia ... hypertension, pulmonary ... #Management #Cardiology ... dCHF #Diastolic #Treatment
Treatment of Stable Narrow-Complex Tachycardia
Regular Rhythm:
 • Attempt vagal maneuvers
 • Give adenosine 6 milligrams IV
Treatment of Stable ... with caution in pulmonary ... fibrillation or ... #management #cardiology ... #algorithm
Atrial Fibrillation (A-Fib) Summary

Symptoms:
• Palpitations, light-headedness, dizziness, dyspnea, exercise intolerance, chest pain, near-syncope, syncope.

Why?
Cardiac:
	• Valvular heart
Atrial Fibrillation ... Decompensated HF • New ischemia ... Noncardiac: • Pulmonary ... Fibrillation - ... diagnosis #management #cardiology
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
INITIATIVE ALGORITHM ... Infarction  Ischemic ... Obtain femoral arterial ... #Algorithm #DCSI ... Initiative #Management #Cardiology
Severe Heart Failure & Cardiogenic Shock - Management Checklist 
Evaluation 
 - EKG & echocardiography
& Cardiogenic Shock ... function tests if shock ... antiarrhythmics - Ischemic ... Revascularization, treatment ... #HeartFailure #Cardiology
Premature Ventricular Complexes (PVC's) - Summary Framework

Why PVCs?  Can be the first manifestation of cardiac
• Myocardial ischemia ... • Underlying ischemic ... fibrillation ... more intensive treatment ... #differential #cardiology