Atrial Fib Basics
This arrhythmia is caused by chaotic atrial depolarization, often triggered by ectopic foci near this anatomic structure.
What are the pulmonary veins?
This nondihydropyridine calcium channel blocker is used for rate control in atrial fibrillation by slowing AV nodal conduction.
What is diltiazem?
This anticoagulant inhibits vitamin K epoxide reductase, decreasing synthesis of factors II, VII, IX, and X, plus proteins C and S.
What is warfarin?
This is the classic chest pain description in acute pericarditis.
What is sharp pleuritic chest pain that improves by leaning forward?
This is the classic EKG finding in atrial fibrillation.
What is irregularly irregular rhythm with absent discrete P waves?
This common structural heart change increases the risk of atrial fibrillation by stretching atrial tissue.
What is left atrial enlargement?
These two drug classes are first-line for rate control in stable atrial fibrillation because they slow conduction through the AV node.
What are beta blockers and non-dihydropyridine calcium channel blockers?
These direct oral anticoagulants directly inhibit factor Xa. Name one.
What are apixaban, rivaroxaban, or edoxaban?
These are common infectious causes of acute pericarditis: one viral group and one bacterial disease.
What are viral infections such as coxsackie/other enteroviruses, and tuberculosis or bacterial infection?
This EKG pattern is classic for acute pericarditis.
What is diffuse ST elevation with PR depression?
In atrial fibrillation, the atria do not contract effectively, leading to blood stasis and thrombus formation most commonly in this structure.
What is the left atrial appendage?
Diltiazem works by blocking these channels in nodal tissue, slowing AV nodal conduction and increasing AV nodal refractoriness.
What are L-type calcium channels?
This drug reverses dabigatran.
What is idarucizumab?
This anti-inflammatory drug disrupts microtubule polymerization and is used in acute pericarditis to reduce recurrence.
What is colchicine?
A patient has an irregularly irregular narrow-complex tachycardia with no visible P waves. This diagnosis is most likely.
What is atrial fibrillation with rapid ventricular response?
This is the main pathophysiologic reason atrial fibrillation increases stroke risk.
What is stasis of blood in the left atrium/left atrial appendage causing thrombus formation?
This antiarrhythmic is useful for rhythm control, especially in patients with structural heart disease, because it prolongs repolarization and refractory period.
What is amiodarone?
A patient with atrial fibrillation on apixaban develops life-threatening bleeding. This targeted reversal drug may be used.
What is andexanet alfa?
This life-threatening complication of pericardial effusion impairs ventricular filling because fluid under pressure compresses the heart.
What is cardiac tamponade?
An ECG shows diffuse concave ST elevations and PR depression rather than regional ST elevations. This diagnosis is most likely.
What is acute pericarditis?
This management strategy is preferred immediately in an unstable patient with atrial fibrillation causing hypotension, altered mental status, ischemic chest pain, or acute heart failure.
What is synchronized cardioversion?
This is the key difference between rate control and rhythm control in atrial fibrillation.
What is rate control lets AF continue but slows ventricular response, while rhythm control attempts to restore or maintain sinus rhythm?
This lab value is used to monitor warfarin therapy, because warfarin reduces synthesis of vitamin K-dependent clotting factors.
What is the INR?
This triad is classically associated with cardiac tamponade.
What is Beck triad: hypotension, JVD, and muffled heart sounds?
EKG clue:
A rhythm strip shows:
This diagnosis is most likely.
What is atrial fibrillation?