Atrial Flutter

Question 1

Aetiology

Answer 1

• Structural causes:
  Heart failure, valvular heart diseases, congenital heart defects
  Lead to scarring/dilation of atria
  Promote development of atrial flutter
• Complication after heart surgery:
  Procedure may caused scarring/damage to heart
• Other conditions:
  Thyroid disease, COPD, sleep apnea
• Substance abuse
• Idiopathic: no known cause

Question 1

What is Atrial Flutter?

Answer 1

• Arrhythmia (abnormal heart rhythm), rapid and regular atrial contractions of heart
• Normal electrical signal disturbed and new circular electrical signal forms in place
• Rapid and regular contraction of atria, ventricles cannot pump blood quickly as atria= cardiac strain and decreased cardiac output
• HR: 150-300

Question 2

Pathophysiology

Answer 2

• Abnormal electrical activity in RA= rapid and regular electrical impulse=override normal electrical activity of heart
• Rapid and irregular atrial contraction=increased and irregular HR
• Reduced cardiac output=poor blood flow to body
• Blood pooling and increased risk of thrombus= blot clot formation

Question 3

Risk Factors

Answer 3

• Old age, heart disease, previous heart surgery, other medical conditions
• substance abuse, family history of condition, obesity/sedentary lifestyle

Question 4

Signs/symptoms

Answer 4

• Tachycardia: HR 150-300bpm
• SOB
• Fatigue
• Chest pain
• Dizziness
• Syncope

Question 5

Investigations

Answer 5

• ECG,24/48 ECG,ECHO
• Bloods: rule out thyroid disease
• CXR: detects fluid accumulation in lungs.
• Cardiac MRI: check heart structure

Question 6

Management

Answer 6

• Meds: beta blockers, calcium channel blockers, antiarrhythmic medicines (digoxin)
• Ablation
• Electrical cardioversion
• Pacemaker
• Prevent thromboembolism with appropriate anticoagulation.