AFib in Special Populations

Abstract: For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This review addresses the clinical characteristics of each of these presentations in order. For all patients with AFib, of either gender or any age, the greatest risk is failure to prescribe anticoagulation therapy, with currently only about half of these patients are being prescribed anticoagulation therapy, a percentage that is often much lower in the elderly, where only about 1 in 3 eligible patients receive anticoagulation. This highlights the most important clinical point for physicians: first, diagnose! This means ensuring the simple procedure of taking the pulse; if that is irregular, then record the ECG and look for AFib. After these 2 simple steps, physicians should be aware of the 2 most important risk scoring systems at present, CHADS2, which has been updated as the CHAD2DS2 vascular score (CHA2DS2-VASc); the latter takes gender into account and is a more sensitive scoring system for differentiating truly low-risk patients from those who may appear to be low risk, but actually are at significant risk. As discussed, while the 2012 ES...
Source: The American Journal of Medicine - Category: Journals (General) Authors: Tags: CME multimedia activities Source Type: research