REASONS FOR INAPPROPRIATE EMERGENCY DEPARTMENT ATTENDANCES IN PATIENTS WITH A HISTORY OF ATRIAL FIBRILLATION: RESULTS FROM THE MULTICENTRE AF-ED TRIAL

2019 ◽  
Vol 73 (9) ◽  
pp. 558
Author(s):  
Ben Glover ◽  
Kathryn L. Hong ◽  
David Bakker ◽  
Jason Baley ◽  
Corinne Babiolakis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
History Of

Qualität des Antikoagulationsmanagements bei ambulanten Patienten mit Vorhofflimmern

Praxis ◽  
2003 ◽  
Vol 92 (21) ◽  
pp. 991-995 ◽  
Author(s):  
Gubler ◽  
Martina ◽  
Arpagaus ◽  
Dieterle
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Oral Anticoagulation ◽  
Medical Emergency ◽  
Psychiatric Disease ◽  
Recurrent Falls ◽  
History Of ◽  
Acute Condition

Many patients with atrial fibrillation do not receive anticoagulation due to accepted contraindications but also due to considerable underuse. We screened 2215 consecutive patients when they entered the Medical Emergency Department for any acute condition. The decision on correct use or underuse of oral anticoagulation was made from the charts by consensus of two experienced physicians. The prevalence of atrial fibrillation was 3.7%. 43 of 83 patients with atrial fibrillation had oral anticoagulation (52%, mean age 76 years). 32 patients were treated with Aspirin only (38%, mean age 79 years). 29 patients (35%) did not receive anticoagulation because of accepted contraindications, i.e., dementia and risk for recurrent falls (n = 16), history of bleeding (n = 6), drug malcompliance due to forgetfulness (n = 4) and psychiatric disease (n = 1). Underuse of anticoagulation occurred only in three patients (4%, unclear reasons in two patients, patient's unwillingness in one patient). Conclusion: We did not observe substantial underuse of anticoagulation in patients with atrial fibrillation.

scholarly journals Anterior Mediastinal Mass Causing Intermittent Atrial Fibrillation

2021 ◽  
Author(s):  
Adam M Spanier ◽  
Garrett R Evans ◽  
Hugh M Hiller
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Mediastinal Mass ◽  
Mass Effect ◽  
Metabolic Effects ◽  
Anterior Mediastinal Mass ◽  
Chest Discomfort ◽  
Rare Finding ◽  
Ventricular Response ◽  
History Of

ABSTRACT Mediastinal masses are a rare finding in the emergency department and typically present with vague chest complaints such as chest discomfort, chest pain, or dyspnea. Rarely do these tumors present with dysrhythmias, and when dysrhythmias are present, they typically arise secondary to endocrine or metabolic effects exerted by the tumor. Here we report a case of a patient who presented to the emergency department with atrial fibrillation with rapid ventricular response, concomitant with a history of recurrent palpitations that were previously aborted with self-induced vagal maneuvers. Upon further investigation, the patient had an anterior mediastinal mass, diagnosed as a thymoma, suspected to be contributing to his presenting dysrhythmia through mass effect.

scholarly journals Acutely Onset Amiodarone-Induced Angioedema in a Patient with New Atrial Fibrillation

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Hossein Vakili ◽  
Isa Khaheshi ◽  
Mehdi Memaryan ◽  
Habib Haybar ◽  
Shooka Esmaeeli
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Coronary Artery ◽  
Sinus Rhythm ◽  
Rate Control ◽  
Drug Eluting Stent ◽  
Rare Side Effect ◽  
Intravenous Amiodarone ◽  
History Of ◽  
Drug Eluting

A 50-year-old man was admitted to our emergency department due to new episode of palpitation. He had history of angioplasty of right coronary artery (RCA) with drug eluting stent 2 years ago. His electrocardiogram revealed atrial fibrillation (AF). Intravenous amiodarone 150 mg during 10 minutes and then 1 mg/min infusion were started to achieve rate control and pharmacologic conversion to sinus rhythm. After 60 minutes of starting amiodarone infusion, he developed swelling of the skin around his mouth and eyes, and also mucosa of the mouth, eyes and tongue. To conclude, angioedema should be considered a rare side effect of amiodarone which is used broadly in cardiovascular field.

scholarly journals Calcific Pericarditis

2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Ben J. Wilson MD
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Clinical Examination ◽  
Past History ◽  
Vital Signs ◽  
Shortness Of Breath ◽  
History Of ◽  
Jugular Venous Distension ◽  
Pedal Edema

An 84-year-old woman presented to the emergency department with progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. She had a past history of atrial fibrillation and was taking digoxin. Clinical examination revealed normal vital signs, 6 cm of jugular venous distension with Kussmaul’s sign, a pericardial knock, and pedal edema.

scholarly journals Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033482
Author(s):  
Kathryn Lauren Hong ◽  
Corinne Babiolakis ◽  
Brigita Zile ◽  
Milena Bullen ◽  
Sohaib Haseeb ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Logistic Regression ◽  
Content Analysis ◽  
Random Effects ◽  
Qualitative Content Analysis ◽  
Primary Objective ◽  
Urgent Care ◽  
Ventricular Rate ◽  
History Of

ObjectivesThe primary objective of this study was to ascertain the reasons for emergency department (ED) attendance among patients with a history of atrial fibrillation (AF).DesignAppropriate ED attendance was defined by the requirement for an electrical or chemical cardioversion and/or an attendance resulting in hospitalisation or administration of intravenous medications for ventricular rate control. Quantitative and qualitative responses were recorded and analysed using descriptive statistics and content analysis, respectively. Random effects logistic regression was performed to estimate the OR of inappropriate ED attendance based on clinically relevant patient characteristics.ParticipantsParticipants ≥18 years with a documented history of AF were approached in one of eight centres partaking in the study across Canada (Ontario, Nova Scotia, Alberta and British Columbia).ResultsOf the 356 patients enrolled (67±13, 45% female), the majority (271/356, 76%) had inappropriate reasons for presentation and did not require urgent ED treatment. Approximately 50% of patients(172/356, 48%) were driven to the ED due to symptoms, while the remainder presented on the basis of general fear or anxiety (67/356, 19%) or prior medical advice (117/356, 33%). Random effects logistic regression analysis showed that patients with a history of congestive heart failure were significantly more likely to seek urgent care for appropriate reasons (p=0.03). Likewise, symptom-related concerns for ED presentation were significantly less likely to result in inappropriate visitation (p=0.02). When patients were surveyed on alternatives to ED care, the highest proportion of responses among both groups was in favour of specialised rapid assessment outpatient clinics (186/356, 52%). Qualitative content analysis confirmed these results.ConclusionsImproved education focused on symptom management and alleviating disease-related anxiety as well as the institution of rapid access arrhythmias clinics may reduce the need for unnecessary healthcare utilisation in the ED and subsequent hospitalisation.Trial registration numberNCT03127085

The Role of HbA1c on Mortality in Patients with Medical History of Ischemic Stroke and Paroxysmal Atrial Fibrillation

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2406-PUB
Author(s):  
KONSTANTINA KANELLOPOULOU ◽  
IOANNIS L. MATSOUKIS ◽  
ASIMINA GANOTOPOULOU ◽  
THEODORA ATHANASOPOULOU ◽  
CHRYSOULA TRIANTAFILLOPOULOU ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Medical History ◽  
Paroxysmal Atrial Fibrillation ◽  
History Of

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

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