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Atrial Fibrillation (Examination (Significant Negatives (Murmur, Evidence…

- - - - Rate control: diltiazem or metoprolol
      - Start LMWH
      - Cardiovert: DC or medical (flec or amiodarone)
  - - - 2nd: add digoxin (not monotherapy)
- - - - AF: pulse stays irregularly irregular
      - VE: ↑ HR → regular pulse
        ↓ diastole time closes window for ectopics
- - - - CCF
        HTN
        Age≥75 (2 points)
        DM
        Stroke or TIA (2 points)
    - - Vascular disease
        Age: 65-74yrs
        Sex: female
    - - 0: aspirin
      - ≥1: Warfarin (INR 2-3)
        
        Contraindications
        
        Bleeding diathesis
        
        Compliance issues: dosing, monitoring
        
        Risk of falls
        
        PUD
        
        Pregnancy
        
        Pt. choice
        
        Complications
        Bleeding
        Osteoporosis
        
        Advice
        
        Requires regular monitoring and titration of dose
        
        Avoid certain foods: e.g. grapefruit
        
        Care starting new meds
        
        Wear medic alert bracelet
        
        Come to hospital if uncontrolled bleeding