In part 1 of this 7-part series, Dr. Rezaie discusses initial ED evaluations of patients with Afib and flutter including examples of possible diagnostics and testing.
Faculty: Salim R. Rezaie, MD, FACEP
Salim R. Rezaie, MD, FACEP: Greater San Antonio Emergency Physicians (GSEP)
Director of Clinical Education | Associate Clinical Professor at University of the Incarnate Word school of Osteopathic Medicine | Previous Editor in Chief of Emergency Physicians Monthly Medical Director of IA MED Emergency Medicine/Internal Medicine | Creator/Founder of REBEL EM | Twitter: @srrezaie
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- [Salim] Welcome to MicroEd, quick facts for big issues. My name is Salim Rezaie, community ER doc down in San Antonio, Texas. This will be part one of a seven-part series on atrial fibrillation and flutter. Specifically for part one, we'll be talking about initial ED evaluations of these patients. Now, as our population gets older, this is going to be a more common diagnosis that we make. This will probably be one of the most frequently diagnosed arrhythmias in the emergency department. It's important to get a careful history, and pay attention to the timing and any previous episodes that patients may have. What we're looking for are reversible causes of the AFib and flutter. Diagnostic studies and testing will be completely dependent on what your differential diagnosis is. This could include an EKG, a troponin, a BNP, a transthoracic echocardiogram, chest X-ray, CBC, a CMP. And don't forget about magnesium because hypomagnesemia can do this. Thyroid studies looking for that hyperthyroid state. And then, our favorite test in emergency departments is the D-dimer or CT pulmonary angiogram if we're suspicious of a pulmonary embolism. Coagulation studies if we're thinking about anticoagulation. A drug of abuse screen. And then, a pregnancy test for women who are of reproductive age. Thank you for watching. Now stay tuned for part two, where we'll discuss determining eligibility for cardioversion.