Atrial flutter in the elderly
Introduction
Introduction to atrial flutter in the elderly Atrial flutter can be considered as an intermediate type between atrial tachycardia and atrial fibrillation. When the atrial ectopic pacemaker frequency reaches 250-350 beats/min and is regular, the atrial rapid and coordinated contraction is called Atrial flutter. basic knowledge The proportion of illness: 0.001% Susceptible people: the elderly Mode of infection: non-infectious Complications: angina pectoris hypotension heart failure
Cause
The cause of atrial flutter in the elderly
Causes:
Mostly organic heart disease, more common in coronary heart disease, high blood pressure, pulmonary heart disease, pulmonary embolism, sick sinus node and so on.
Pathogenesis:
Looping agitation: Animal experiments have confirmed that atrial flutter is the result of impulsive circular motion in the atrium, and some people use aconitine to cause abnormal atrial autopsy to cause atrial flutter or atrial fibrillation.
Prevention
Elderly atrial flutter prevention
The majority of atrial fibrillation and atrial flutter in the elderly occur in coronary heart disease, hypertensive heart disease, pulmonary heart disease, hypokalemia, acute lung infection or digitalis poisoning. Therefore, the cause should be first identified and the cause should be actively treated. Generally, before the onset of atrial fibrillation or atrial flutter, frequent frequent room early, should be actively treated to prevent the development of atrial fibrillation or atrial flutter. For repeated frequent authors, you can explore appropriate antiarrhythmic drugs for a long time with minimum dose. Maintain and prevent recurrence.
Complication
Elderly atrial flutter complications Complications, angina, hypotension, heart failure
Severe cases can be complicated by angina, hypotension, heart failure and so on.
Symptom
Atrial flutter symptoms in the elderly Common symptoms Hypotension Heart palpitations Block tachycardia Dizziness angina shock
1. When the atrial flutter is 1:1, it can cause the ventricular rate to reach 250 times/min, which may cause hypotension, dizziness, palpitations, angina, and even cardiogenic shock.
2. The jugular vein beats faster than the ventricular rate.
3. Compression of the carotid sinus can aggravate atrioventricular block and temporarily slow the ventricular rate.
4. Cardiac auscultation, the most common is a fast and regular heart rate, about 150 beats / min, the ratio of the chamber is 2:1, when the proportion of the chamber is 3:1 or 4:1, the heart rate is reduced. Slow, at this time careful auscultation can hear fast and low atrial contraction.
Examine
Elderly atrial flutter check
Atrial flutter has a primary disease such as rheumatic heart disease, and patients with pulmonary heart disease can have elevated white blood cells. Pulmonary heart disease patients have pulmonary infection, X-ray abnormalities.
Diagnosis
Diagnostic identification of atrial flutter in the elderly
Diagnostic criteria
The main means of diagnosis should still rely on the electrocardiogram, which is characterized by:
1 The electrocardiogram P wave disappears, and the shape, spacing and amplitude are absolutely neatly serrated F-wave, the frequency is 250-350 times/min, and the common atrial flutter is mostly 2:1 conduction;
2 ECG features can be divided into 2 types: I type: flutter wave frequency 300 times / min, II, III, aVF lead F wave is negative, type II: flutter wave frequency 250 times / min, II, III, aVF lead F wave erect, pacing treatment can terminate type I, invalid for type II;
3 Atrial flutter with indoor differential conduction, bundle branch block or pre-excitation syndrome, should pay attention to the identification of ventricular tachycardia.
Differential diagnosis
Atrial flutter should be differentiated from sinus tachycardia, atrial paroxysmal tachycardia, and ventricular paroxysmal tachycardia.
