Atrial fibrillation - page 4

by Soliloquy 4,082 Views | 34 Comments

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


  1. 0
    Quote from GrnTea
    The paper you quote is from Sweden and may have suffered from translation problems. it says, "When septae fail to fuse, how*ever, the PFO is a potential tunnel that can be opened by reversal of the interatrial pressure gradient. PFO is the most common form of right-to-left circulatory shunt (RLS)."


    I think we agree that a PFO is a potential cause of right-to-left shunt, but since many PFOs are discovered incidentally on autopsy for people who have never suffered any sort of CVA, it's a stretch to say a PFO *is* an RLS. It IS the most common finding associated with RLS, but that's different.

    The CVA patients you've seen with a potential culprit PFO are all over 50. Since they have had their PFOs since birth (actually, before birth) (barring exceptional circumstances), it is clear that the mere existence of a PFO does not inevitably cause stroke. But I think we're probably done explaining this now .
    The quote is from Swedish Medical Center in Seattle, Washington, not from Sweden. It was not translated.

    Not every PFO causes a CVA, but it's been well established that the existence of a PFO correlates with a higher risk of CVA which speaks to my original point; CVA's due to venous/R sided emboli are not impossible and occur more often than we often give them credit for due to a misunderstanding of the prevalence of R to L shunting.
  2. 0
    In order to be a professional Registered Nurse, one must develop a scientific knowledge base. Why in the world are nursing students using Wikipedia and google? What happened to textbooks, journals, and databases?
  3. 2
    Quote from medicmatt44
    In order to be a professional Registered Nurse, one must develop a scientific knowledge base. Why in the world are nursing students using Wikipedia and google? What happened to textbooks, journals, and databases?
    I cringe to say this, but....

    Provided its well cited (and any RN should be wise enough to check for citations) it's not the worst source.

    And Google Scholar is a great research database.
    GrnTea and Esme12 like this.
  4. 0
    I think we need to look at the two options and select the BEST answer. In this case MI versus PE...It will definitely be a PE because with a-fib we are mainly concerned with clots from stagnant blood. Yes, the majority of clots occur in the left side and can lead to a stroke but this does not eliminate the fact that they can potentially occur in the right side as well.

    MIs are mainly caused by CAD (atherosclerosis), or any situation that decreases O2 supply to the heart, CMP etc. Like the above answers said, MIs lead to a-fib; as for the response that said PE is a lung issue and not a heart issue it is always important to understand your patho first and foremost; yes PE occur in the lungs but it has everything to do with the circulatory system.
  5. 0
    Left sided clots can, in fact, go down the coronary arteries and cause myocardial infarct. Not as easy to do, though, if you think of the mechanics of the contracting ventricle, the valve cusps, and the location of the ostia and the resulting hemodynamics.


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