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A477 L8 Atrial fibrillation and Venous Thromboembolism Events - Coggle…
A477 L8 Atrial fibrillation and
Venous Thromboembolism Events
What is atrial fibrillation?
Irregular and very rapid heart rhythm
Increases risk of stroke,heart failure and other heart related complications
Symptoms
Palpitations, shortness of breath, fatigue, dizziness, chest discomfort
How does AF lead to heart failure and embolic stroke?
The top chambers, the atria, they don't pump, they quiver
The heart can't function if two of the chambers, the atria, don't work normally, leading to heart failure
Some blood just sits at the quivering atria, don't move down the ventricles and become stagnant, which it clots.
Clots can be transported in blood vessels and clog them, if the clot goes to the brain, it causes a stroke
Risk factors for AF
Genetics, age, being male, Chronic disease like hypertension, diabetes, other cardiovascular diseases: Heart failure, coronary artery disease, valvular heart disease, Unhealthy lifestyle: Smoking, alcohol consumption, lack of fitness, obesity
What is venous thromboembolism (VTE)
When a blood clot forms, in deep veins of leg, groin or arm (Deep vein thrombosis) and it may travel in circulation and lodge in lungs (Known as pulmonary embolism)
Risk factors
Hypercoagulability of blood from cancer/thrombophilia/inflammatory disease/birth control pills/blood clotting disorder/pregnancy, Stasis of blood, surgery or chemical irritation/inflammation
Symptoms
Deep vein thrombosis affects one side of body, the clot can cause leg pain or tenderness of thigh or calf, leg swelling, skin that feels warm to touch, reddish discoloration
Pulmonary embolism: Unexplained shortness pf breath or difficulty breathing, rapid breathing, chest pain under rib cage which may get worse with deep breathing, fast heart rate, passing out, coughing w/w/o blood, anxiety or dread
Pharmacological treatment: Direct oral anticoagulants: Direct factor Xa inhibitor( Rivaroxaban, Apixaban) or Direct Factor lla inhibitor (Dabigatran), Vitamin K epoxide reductase antagonist(Warfarin), Heparins
Anticoagulants do not dissolve existing blood clots but they prevent new clots from forming, DOAC (Novel oral anticoagulants) is preferred over Warfarin/LMWH in general population
Nonpharmacological advice
After surgery/hospitalization-> Keep moving, consider graduated compression stockings or massaging compression devices if recommended, take prescibed medication.
For Blood clots-> Perform simple exercises of flexing/extending ankles, knees, or calf muscles, walk around, compression socks, avoid alcohol and be properly hydrated
Platelets are involved in thrombosis affecting arterial system, known as white thrombus, thus antiplatelets are used for white thrombi,
Red thrombus-> Fibrin and red blood cells are involved in thrombosis affecting venous system, known as red thrombus, thus anticoagulants are used for red thrombi
AF management
Initiation of oral anticoagulants(DOAC or Warfarin)
Weight loss>10%, target of 210 minutes per week of moderate-vigorous exercise, cease smoking and alcohol consumption, Optimize HTN and DM management
Rate control: Non-DHP CCBs, BB or digoxin, lower resting heart rate <110 bpm(lenient), <80bpm(strict)
Rhythm control: amiodarone, BB (sotalol only), both FYI, or Catheter ablation (only if medications not effective)-> a procedure that very carefully destroys diseased area of heart and interrupts abnormal electrical currents