Before starting this case it is recommended that you be familiar with ECGs as you will be interpreting them heavily.
Learning outcomes
Tutorial 1
History taking
Cardiovascular examination
Lab testing
what to order
Interpreting results
Interpreting ECG
Atrial fibrillation
Familial hyperlipidaemia
Drugs
Cardioversion
Interpreting ECG
Drugs for real
Adherence
IDL
YOu are given these resources: https://bpac.org.nz/2024/af.aspx http://www.nice.org.uk/guidance/ng196 https://doi.org/10.1093/eurheartj/ehae176 https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 https://otago.libguides.com/medicine http://www.medsafe.govt.nz/
You are asked to come up the answer for these questions:
- Where in the heart are clots (thrombi) likely to form?
- What are the possible consequences if a thrombus detaches (embolises)?
- What medicines can be used to prevent thrombus formation? Be sure you can discuss warfarin, the Novel Oral Anticoagulants (NOACs) / Direct Oral Anticoagulants (DOACs).
- How to they work? Where do they exert an influence on the coagulation cascade?
- How effective are these medicines?
- What are their adverse effects?
- How can you monitor the effects of these medicines? How can this monitoring be used to reduce the risk of adverse events?
- What are the risk/benefit ratios for using anticoagulant therapy in atrial fibrillation?
- What are CHADS2 and CHA2DS2-VASc scores. What do they measure and what does the score mean for management strategies?
Tutorial 2
You are asked to come up with a treatment plan for 3 scenarios, 1. heart rate and blood pressure control, 2. stroke prevention, and 3. managing risk factors and comorbidities
You are asked about catheter ablation
you are asked what information someone should be given before deciding on a catheter ablation operation
CHA2DS2-VASc
You have been asked about the CHADS2 and the CHA2DS2-VASc scores, what they are and how they work
See more here CHA2DS2-VASc
The CHA2DS2-VASc is a tool to estimate risk of stroke in patient based on their history and physical characteristics.