Cardio Question

I guess I don't really understand the question.

TEE: http://www.heartsite.com/html/tee.html

Simply put it is an ultrasound of the heart obtained from behind the heart via the esophagus.

Heparin Drip: Heparin is a fast acting, temporary anti-coagulant. Basically it makes the platelets of the blood "slippery" so they don't stick together as well and form clots. This is sometimes used in new onset atrial fibrillation patients until they can begin Warfarin Therapy. Heparin is titrate (adjusted) every so many hours (per hospital protocol) after blood work is obtained.

Warfarin acts basically like heparin however it is an oral form, taken each day in very specific doses to maintain a certain level of anticoagulation.

For our hospital a patient will be on a heparin drip while Coumadin "loading" aka dosing each day until their PT/INR is between 2 and 3 (depending on the MD).

Cardioversion is an option for patients in new onset afib. Sometimes there is an aberrant heart cell (because all heart cells can beat independantly, but are controlled by the conduction system of the heart) that causes inappropriate movement of the atrial wall. A cardioversion is a temporary interruption of the heart beat. Bascially you can shock someone under sedation, and with parameters or you can use a medication administered very rapidly to "stun" the heart. I have actually witnessed the physical cardioversion and the patient returned to Normal Sinus Rhythm.

If cardioversion fails patients can also opt for ablation, a process where they physically isolate the aberrant cell(s) and zap them.

Hope this helps...and isn't for homework lol.

Tait

If I had to put them in sequence, I'd say heparin gtt, TEE, cardioversion, daily warfarin.

Think about what the major risk of atrial fibrillation is....

What does heparin do?

What does TEE show (hint: Left Atrium)?

What is cardioversion?

What does warfarin do?

Heparin drip......APTT every 6 hours then drip titrated need to watch for bleeding (normally given to patient to newly diagnosed bloodclot

Cardioversion.... given to reverse the cardiac rhythm, sometimes internally wired other are in CPR by defib

Daily Warfarin.....bloods taken and check for Coags . INR needed predosing, watch for presence of bleeding. Give education not to eat antidote such as green leavy vegies.