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Wednesday, March 6, 2013

Atrial Fibrillation

PBL write up- The dizzy overwhelmmer

Scenario:

Laura is 66 and is having treatment for an overactive thyroid. obscure from that she says she is generally in good health. She exercises regularly, goes jogging once or twice a week and swims at the local swim pool about once a week.

She goes to see her GP because of bouts of dizziness and shortness of breath. On questioning her he establishes that these snuff it only after jogging or swims. After her swim last week she experienced severe dizziness and palpitations which sooner alarmed her.

On examination her peak flow was inside the normal range and no abnormal sounds were noned on chest auscultation. Her mall rate at rest was carbon b/m and her blood pressure 160/90 mmHg. She admitted that she still smokes occasionally (although she is trying to give up), and drinks alcohol alternatively more than she should, varying between 20-28 units a week.

The GP refers her to the heart and chest clinic at the local hospital for further tests. present she is fitted with a 24-hour ECG Holter monitor and asked to go jogging trance wearing it. The monitor gives a definite diagnosis, and Laura is sent menage with medication that seems to resolve the problem. However, she is warned that if the dizziness recurs, more active interposition may be necessary in the future.

Objectives:

1.

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Terms

2. Physiology of the heart- electrical input/ conduction

3. Thyroid- basic function, hyperthyroidism and pharmacology of hyperthyroidism

4. ECG- what is it and possible diagnoses

5. Atrial fibrillation- pathophysiology, symptoms, gamble factors, diagnosis, investigations, treatment, prognosis.

1.Terms

Palpitations: Palpitations describes the sensation of irregular, rapid or forceful heartbeats, or withal just an awareness of ones own heartbeat. It brush off be due to ectopic beats, various tachycardias or AF. It is not necessarily associated with pathology and is often associated with anxiety

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