SAQ 839 – Cardiology – new atrial fibrillation management

A 70-year-old man presents to your ED with a two-day history of intermittent palpitations and lethargy. His only past medical history is hypertension, and his regular medications are irbesartan and aspirin. He lives alone, is independent with activities of daily living and drinks two glasses of wine with dinner each night.

His ECG shows atrial fibrillation with 1 mm ST depression in V3-V6.

List your top two (2) treatment options for this patient and provide a justification for each.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Treatment</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td>1</td> <td></td> </tr> <tr> <td>2</td> <td></td> </tr> </tbody> </table> <p>

/ 4

After treatment, he remains in AF at 100-120/min with BP 120/70 mmHg. Serial troponins are minimally elevated and he is admitted to the short stay unit for telemetry and management. What would you prescribe for ongoing management of the new AF, and why?

(Marked out of 2.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Item</th> <th>Response</th> </tr> </thead> <tbody> <tr> <td>Ongoing prescription</td> <td></td> </tr> <tr> <td>Justification</td> <td></td> </tr> </tbody> </table> <p>

/ 2

The junior short stay unit doctor asks whether he should be discharged with anticoagulation. State six (6) points describing and reasoning through your approach to anticoagulation in this patient.

(Marked out of 6.0)

/ 6

Total Score: 0 / 12

Percentage: 0%