Atrial fibrillation physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The hemodynamic stability of the patient should be first assessed. The patient should also be examined for the presence of reversible causes of atrial fibrillation. A study of routine pulse checks or [[electrocardiograms]] during routine office visits, found that the annual rate of detection of atrial fibrillation in elderly patients improved from 1.04% to 1.63%. | The hemodynamic stability of the patient should be first assessed. The patient should also be examined for the presence of reversible causes of atrial fibrillation. A study of routine pulse checks or [[electrocardiograms]] during routine office visits, found that the annual rate of detection of atrial fibrillation in elderly patients improved from 1.04% to 1.63%. This implies that the [[sensitivity (tests)|sensitivity]] of the routine examination is 64% (1.04/1.63). | ||
==Physical Examination== | ==Physical Examination== |
Revision as of 10:04, 24 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The hemodynamic stability of the patient should be first assessed. The patient should also be examined for the presence of reversible causes of atrial fibrillation. A study of routine pulse checks or electrocardiograms during routine office visits, found that the annual rate of detection of atrial fibrillation in elderly patients improved from 1.04% to 1.63%. This implies that the sensitivity of the routine examination is 64% (1.04/1.63).
Physical Examination
Vital Signs
The following are some common vital sign findings in patients with AF:[1]
- Pulse:
- In the setting of drug toxicity or hypothermia, the pulse may be slower.
- The pulse is irregularly irregular. In general the heart rate is 100-140 beats per minute.
- In the presence of atrial fibrillation the pulse could be 150-170 beats per minute (rare).
- Blood pressure:
- The blood pressure should be checked as hypertension is one of the leading causes of atrial fibrillation.
- Narrow pulse pressure (when systolic blood pressure minus diastolic blood pressure is < 25 mm Hg) usually suggest congestive heart failure.
Eye
- Exopthalmos may suggest hyperthyroidism.
- Retinal hemorrhage may be seen in malignant hypertension
Neck
- The patient should be examined for the presence of thyroid abnormalities.
Heart
- The patient should be examined to assess for the presence of congestive heart failure or hypertrophic obstructive cardiomyopathy.
- S3 and S4 would suggest heart failure.
- Heart murmurs, their intensity, postural changes can identify different valvular heart diseases.
Lung
- Rales would suggest heart failure.
Lower Extremities
- Lower leg edema may suggest cardiac failure.
References
- ↑ Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee (2021). "Atrial fibrillation: diagnosis and management-summary of NICE guidance". BMJ. 373: n1150. doi:10.1136/bmj.n1150. PMID 34020968 Check
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value (help).