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ATRIAL FIBRILLATION (Pathophysiology (• Atrial fibrillation (AF) is a…
ATRIAL FIBRILLATION
Pathophysiology
• Atrial fibrillation (AF) is a common arrhythmia, arrhythmia being an irregular heartbeat, rhythm and/or rate.
• AF is caused by fast and irregular electrical signals that are disorganised within the atria.
• The heart is controlled by an electrical system within the sinoatrial (SA) node, in a normal working heart with a heartrate of about 60-100 bpm the electrical signals travel from the left and right atrium causing the heart to contract thus pumping blood into the ventricles.
• Once the electrical signals move through the atria they pass through the atrioventricular (AV) node which is situated between the atria and ventricles.
• Once the ventricles have filled with the blood the electrical signals exit the AV node.
• The electrical signals once entered the ventricle cause a contraction resulting in the blood pumping out of the ventricle and into the lung and body, once the blood has left the ventricles they relax and the process commenced again from the SA node.
• In AF, the atria does not pump all the blood into the ventricles, causing the remaining blood to pool within the atria, this occurs when the upper and lower chambers being the atria and ventricles do not work simultaneously.
• AF is a result of the SA node not producing the electrical signals, the electrical signals are produced from another area within the atria. Due to the electrical signals not being produced by the SA node when they travel through the atria they are not streamlined and working in an organised manner, instead they are disorganised and rapidly spread causing the atria to contract fast and irregular.
• The disorganised electrical signals overwhelm the AV node causing the ventricles to contract fast and irregular.
• The atria contracts faster than the ventricles due to the AV node having to process the electrical signals prior to releasing them into the ventricles.
• Thus, the atria and ventricles do don’t work simultaneously which causes the irregular heartbeat of rhythm and/or rate.
• AF can create a heartrate of about 100-175 bpm.
• AF disrupts not only the blood flow through the heart but also the blood flow through the body, the flow will be irregular in time and mount.
Diagnosis
• The diagnosis of AF can be related to family medical history and an electrocardiogram (ECG) can be used to observe the hearts actions.
• A sign of AF can be a stroke, this is caused by the pooling of blood within the atria which forms into a blood clot, the clot then travels through the blood stream from the heart to the brain.
• Another sign of AF can be heat failure, this is caused because of not enough blood being pumped throughout the lungs and body.
Presentation
• AF does not always present with symptoms such as pain.
• Signs and symptoms related too AF can consist of but are not limited to; shortness of breath, fatigue, chest pain, confusion, palpations and weakness when exercising.
Risk Factors
• The risk of AF increases with age which is in line with other conditions that are more common with age such as; heart failure, rheumatic heart disease, congenital heart defects, pericarditis, structural heart defects and sick sinus syndrome.
• AF can affect millions of people although men are at a higher risk compared to women.
• AF is more common in Caucasians than African or Hispanic American.
• Children do not commonly suffer from AF.
• AF can coincide with heart attacks or post-surgery.
Epidemiology
• AF is caused by a fault within the electrical signals travelling through the heart abnormally.
• AF is generally caused by other underlying conditions such as coronary heart disease, inflammation and/or high blood pressure.
• AF symptoms can be experienced because of unknown causes.
• AF can increase the risk of a stroke and heart failure.
• If the heart has an irregular rhythm/rate that is rapid it can cause pain.
• AF can occur as a once off or can become a long-term problem in some cases.
Emergency Treatment
• In the most serious of cases being systolic of 80, cardioversion is on treatment option to prevent further damage or severity in the condition.
• In less serious cases blood-thinning medication as well as medication to help control the hearts rhythm and rate can be administered.
• Medication administered to control rhythm and rate as well as preventing the formation of blood clots
Pharmacology
• The effects of AF can by managed by administering blood-thinning medications to minimise the chance of a blood clot forming.
• Other medications such as; amiodarone can be administered to regulate the heart rhythm. Beta blockers such as metoprolol are another form of medication that can also be administered to regulate the heart.