Atrial fibrillation - page 2

by Soliloquy

What are people with Atrial fibrillation at risk for? Acute MI or Pulmonary Embolus?... Read More


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    Quote from Esme12
    I refer to wiki very little it isn't a good medical resource....besides not always being right.

    A Fib...and Atrial Fibrillation Medscape: Medscape Access medscape requires registration but it is free and an excellent resource.

    and What is Atrial Fibrillation?

    What is pulmonary embolism, pulmonary emboli
    Hey Esme! Wiki's so awesome though! lol But you're right, it isn't a very good medical resource, especially not for patients. I'll go check out your links on Pulmonary Embolism. I got that answer wrong on the test and someone told me the answer really was suppose to be PE but I couldn't "get" why.
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    Clot formation is more common in the left atrium, largely due to the left atrial appendage, but it does still occur in the right atrium as well. One large study that looked at thrombus occurrance in autopsies of A-fib patients found they occurred in the L atrium in 12% of patients and in the R atrium is 7% of patients, not dramatically different.

    L atrial emboli are more the focus of anticoagulation in A-fib patients in part due to the difference in severity of PE's vs Strokes, PE's can be deadly but are often treatable with minimal residual effects, while strokes often cause long term damage.

    Correlating PE's with A-fib can be difficult because PE's often cause A-fib, making it sort a chicken or the egg thing. PE's cause dilation of the RV and right atrium which stretches the conduction system, making the it more irritable.
    psu_213 likes this.
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    Virchow’s triad in atrial fibrillation and the risk of stroke: Thrombus formation in patients with AF results from stagnant blood in the atria, combined with other physiological derangements.These abnormalities are consistent with the 3 factors first identified by Virchow as contributing to DVT formation. In AF, Virchow’s triad consists of:

    • Stagnant blood flow in the left atrium, visible on an echocardiogram as spontaneous echocontrast
    • Anatomical cardiac wall defects, such as progressive atrial dilatation
    • Abnormal platelet activation and changes in coagulation factors, contributing to an increased propensity for blood clot formation


    Without anticoagulant therapy, patients with AF are at high risk of stroke, as a thrombus that forms in the atria can embolise to block blood flow to the brain.
    Thrombosis and Atrial Fibrillation - Thrombosis Adviser
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    Quote from classicdame
    if the atrium continues to fibrillate the whole "electrical" system of the heart could get short-circuited and then the ventricles might be involved. In other words, it can lead to a lethal rhythm that results in MI.

    Pulmonary has to do the lungs. Of course the heart and lungs work together, but a patient with A-Fib has a cardiac issue, not a lung issue.
    Not quite sure what you mean by that. Many people have afib for years and years without even knowing it; people who have it diagnosed are not at any particularly higher risk because of the afib. Maybe because of what caused the afib in the first place-- an MI, cardiomyopathy, drug toxicity, who knows?-- but afib doesn't cause MI or ventricular arrhythmia all by itself.

    OP, what is afib? What happens to the heart when the atria aren't contracting in a coordinated fashion? What is the normal blood flow path through the heart and lungs? I regret that I can't do this in color showing blue for the venous side and red for the arterial, so you'll have to figure that out yourself (that's why you took anatomy). If a clot develops in the left atrium, where could it go? In the right atrium? There's your answer.

    veins > vena cava > right atrium > pulmonary artery > LUNGS > left atrium > left ventricle > aorta > body > capillary bed > veins ....

    (oh yeah: Atrium and auricle are the SAME THING. Auricle is just the old-fashioned term.)
    KelRN215 and Sun0408 like this.
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    Most LIKELY a PE
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    The big issue with Afib is the risk for clots.
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    Quote from Newgraduatenurse2012
    Most LIKELY a PE
    Actually, no, because clot is more likely to form in the LEFT atrium than the left, so the clot is more likely to exit out the left side of the heart to...?
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    Quote from GrnTea

    Actually, no, because clot is more likely to form in the LEFT atrium than the left, so the clot is more likely to exit out the left side of the heart to...?
    I agree with the previous poster that a PE is more likely then an MI in uncontrolled AF due to the diastolic flow to the coronary circulation. I have sent out a number of patients with PEs 2/2 chronic PAF and I don't recall a situation where it was clear that AF preceded an acute MI.
    Last edit by BostonFNP on Dec 21, '12
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    Again, AF does not cause the MI. An MI could cause AF, though.
  10. 0
    Quote from GrnTea
    Again, AF does not cause the MI. An MI could cause AF, though.
    Exactly, for the OP the best answer would be PE.


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