An 80-year-old woman was admitted with dizziness and atrial fibrillation with rapid ventricular rate, controlled with β-blockers. Echo shows atrial enlargement, EF 50%, no valvular disease. She is now asymptomatic, irregularly irregular at 80/min, BP 130/80. What is the best management of her arrhythmia?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Continue rate control plus long-term anticoagulation
She is elderly, haemodynamically stable and now asymptomatic with a controlled rate on β-blocker, so rate control is the right strategy — rhythm control is favoured mainly in patients <70 years, recent-onset AF with heart failure, or failed rate control. Her CHA₂DS₂-VASc is ≥3 (age ≥75 = 2, female = 1), so she needs long-term anticoagulation.
- Cardioversion (A, B) adds risk without benefit in an asymptomatic 80-year-old with an enlarged atrium.
- Cardioversion without anticoagulation (D) risks stroke.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Emergency electrical cardioversion is for tachycardic or unstable patients. She is stable, asymptomatic and rate-controlled at 80/min.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 7 -
B
ليش غلط
Rhythm control (including chemical cardioversion) is favoured after failed rate control, in recent-onset AF with heart failure, or in patients under 70. None of these fits an asymptomatic 80-year-old.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 7 -
C
ليش صح
Rate control suits a stable, elderly patient with longstanding or recurrent AF, and long-term anticoagulation is started when risk assessment favours it, as here.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 7 -
D
ليش غلط
A score of 2 or more on CHA2DS2-VASc means anticoagulant therapy; she scores at least 3 (age 75 or more = 2, female = 1). Cardioversion without anticoagulation is not appropriate.
✓ Cardiology 🫀.pdf · p. 22
- المصدر
- CARDIOLOGY - ARRHYTHMIA.pdf · p. 7
Cardiology 🫀.pdf · p. 22 - المحاضرة
- Arrhythmia · Cardiology · Module B
- ظهر في
- MED42 Compre B · MED41 ♂ EOM B