Atrial fibrillation physical examination
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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%.[1] This implies that the sensitivity of the routine examination is 64% (1.04/1.63).
Physical Examination
Vital Signs
- Temperature: In the setting of drug toxicity or hypothermia, the pulse may be slower.
- Pulse: The pulse is irregularly irregular. In general the heart rate is 100-140 beats per minute. Rarely is the pulse 150-170 beats per minute in the presence of atrial fibrillation.
- Blood pressure: The blood pressure should be checked as hypertension is one of the leading causes of atrial fibrillation.
Eye
Neck
- The patient should be examined for the presence of or thyroid abnormalities.
Heart
- The patient should be examined to assess for the presence of congestive heart failure or hypertrophic obstructive cardiomyopathy.
References
- ↑ Fitzmaurice DA, Hobbs FD, Jowett S; et al. (2007). "Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial". doi:10.1136/bmj.39280.660567.55. PMID 17673732.