Atrial fibrillation

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What are people with Atrial fibrillation at risk for?

Acute MI

or

Pulmonary Embolus?

Specializes in Hospital Education Coordinator.

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.

Specializes in Emergency, Telemetry, Transplant.

The issue with A fib is that blood stagnates in the heart, usually the left atrium and left auricle. This blood clots. The most common concern is that a clot moves from the atrium into the left ventricle and is "thrown" to the brain....stroke. To be honest, I don't know if such clots ever form on the right side of the heart and move to the lungs causing a PE (for a PE, we most often worry about clots from the deep veins of the legs...a DVT). If the clot forms in the left side of the heart, I'm not sure how often it gets pumped out of the heart and then moves into the coronary arteries, where it can cause an MI (heart attack).

As I said, the most common clot related complication of A fib is a stroke. Both PEs and MIs can 'cause' A fib.

Specializes in ER, progressive care.
The issue with A fib is that blood stagnates in the heart, usually the left atrium and left auricle. This blood clots. The most common concern is that a clot moves from the atrium into the left ventricle and is "thrown" to the brain....stroke. To be honest, I don't know if such clots ever form on the right side of the heart and move to the lungs causing a PE (for a PE, we most often worry about clots from the deep veins of the legs...a DVT). If the clot forms in the left side of the heart, I'm not sure how often it gets pumped out of the heart and then moves into the coronary arteries, where it can cause an MI (heart attack).

As I said, the most common clot related complication of A fib is a stroke. Both PEs and MIs can 'cause' A fib.

Yup, with afib we worry about stroke. You need to make sure the patient is on anticoagulants and stress the importance of them.

Specializes in Trauma Surgical ICU.

A. Fib has the greatest risk for a clot/stoke. The main tx if not converted is anti-coagulation to help prevent clots. Please read up on this, a simple google search will give you a lot of information. MI is rarely mentioned but heart failure is common but the number one risk is stroke.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I think you would learn a lot more if you looked up a fib yourself.

Atrial fibrillation - MayoClinic.com

Hey guys. Even though I learned (from a commercial on atrial fibrillation and yes, google) that someone with A.fib has a greatest risk for stroke, that wasn't a choice on the exam I took. I narrowed it down to two: Acute MI and pulmonary embolism.

I chose Acute MI mainly because I figured that pulmonary embolisms are more of a lung issue and doesn't necessarily have to do with the heart. I also know that arrhythmias can occur after a heart attack, but the question asked, "What would a person with A. Fib be at greatest risk for?"

Thanks for the link, Esme12. In doing a google search on Pulmonary embolisms though, I found an explanation on Wikipedia that talks about people developing PE as a result of obstruction of airflow to the lungs and pressure on the right ventricle. So my thinking is that Pulmonary embolism wouldn't be the right choice, mainly because A. fib would be an issue of the atriums of the heart.

http://en.wikipedia.org/wiki/Pulmonary_embolism

Specializes in Adult Internal Medicine.

We certainly worry about PE with afib. Think about the pathophys: clots form in the atria an escape to a ventricle and are pushed out for systemic circulation. On the left they go to the brain (stroke) on the right they go where?

And there is a big mistake in your description of PE, I would re-read that section on what a PE is.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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

We certainly worry about PE with afib. Think about the pathophys: clots form in the atria an escape to a ventricle and are pushed out for systemic circulation. On the left they go to the brain (stroke) on the right they go where?

And there is a big mistake in your description of PE, I would re-read that section on what a PE is.

Okay. I'll check it out. Thanks for your response!

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.

Specializes in Critical Care.

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.

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