Re: Rapid Afib
My 84 year-old great aunt presented to ED a few months back with chest pain and SOB. The reg basically wanted to send her home because she was 84 and had CCF. Her HR was jumping between 40 and 180bpm. I wanted to know why that wasn't concerning him!!! She was in unstable AF and he wanted to send her home!!!
Anyway, she stayed in hospital for a week and all they did was start her on 625mg of dig and take her off her carvedaoil because they thought it was causing breathlessness. They didn't even bother to get it to a therapeutic dose!
She's currently in hospital again (a different one, thankfully) where she's just been transfered from CCU to HDU and they're using digoxin (250mcg) in combination with metaprolol and lasix to try and slow her heart down and increasing the contractility/effectiveness.
It's interesting because her heart is so complicated (severe right and mild left CCF, unstable AF, mitiral and tricuspid leaks, CAD, hx MI etc) as well as her lungs COPD - yet they're still improving her comfort and.... well, everything!!!
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