Qualität des Antikoagulationsmanagements bei ambulanten Patienten mit Vorhofflimmern

Praxis ◽  
2003 ◽  
Vol 92 (21) ◽  
pp. 991-995 ◽  
Author(s):  
Gubler ◽  
Martina ◽  
Arpagaus ◽  
Dieterle

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.

2020 ◽  
Vol 21 (4) ◽  
Author(s):  
Bory Kea ◽  
Bethany Waites ◽  
Amber Lin ◽  
Merritt Raitt ◽  
David Vinson ◽  
...  

2021 ◽  
Author(s):  
Adam M Spanier ◽  
Garrett R Evans ◽  
Hugh M Hiller

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.


Author(s):  
Tripathi S ◽  
◽  
Sharma JB ◽  
Vijayvergia P ◽  
Khichar S ◽  
...  

Pericardial effusion in commonly seen in-patient with hypothyroidism but effusion large enough to cause cardiac tamponade is not a common presenting feature whereas myxedema coma is a commonly defined medical emergency in-patient with hypothyroidism. We report 2 cases of hypothyroid associated medical emergencies. First case is a young female with history of recurrent pericardial effusion presenting to the emergency department with cardiac tamponade and later on diagnosed as having hypothyroidism. The second patient is a known case of hypothyroidism non-compliant to thyroid supplement and presented with lethargy, fatigue, decreased talking and breathlessness who was later diagnosed as having myxedema coma and impending cardiac tamponade. Both the patient required percutaneous pericardiocentesis and improved with medical management.


2018 ◽  
Vol 131 (3) ◽  
pp. 269-275.e2 ◽  
Author(s):  
Meena P. Rao ◽  
Dragos Vinereanu ◽  
Daniel M. Wojdyla ◽  
John H. Alexander ◽  
Dan Atar ◽  
...  

2019 ◽  
Vol 35 (10) ◽  
pp. S5-S6
Author(s):  
C. Atzema ◽  
C. Jackevicius ◽  
A. Chong ◽  
P. Dorian ◽  
N. Ivers ◽  
...  

2016 ◽  
Vol 18 (4) ◽  
pp. 71-78 ◽  
Author(s):  
Joel A Scott-Herridge ◽  
Colette M Seifer ◽  
Ron Steigerwald ◽  
Glen Drobot ◽  
William F McIntyre

2019 ◽  
Vol 73 (9) ◽  
pp. 558
Author(s):  
Ben Glover ◽  
Kathryn L. Hong ◽  
David Bakker ◽  
Jason Baley ◽  
Corinne Babiolakis ◽  
...  

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