Decision
Suspicion for myocardial infarction, left ventricular dysfunction, thyrotoxicosis, or other underlying pathology?
Yes
- Treat underlying condition
- Consider beta blocker if no contraindications (Class I)
Background
Table 1. Historical Elements That Can Help Identify Underlying Etiology of Atrial Fibrillation / Atrial Flutter
Underlying Cause | Helpful History |
Hypertension | Duration, medications, normal readings |
Heart failure | Dyspnea, fatigue, exercise intolerance, peripheral edema, orthopnea |
Coronary artery disease | Chest pain, radiation of pain, family history of cardiac disease, level of physical activity, stress |
Thyroid disease | Anxiety, tremor, heat intolerance, weight loss, menstrual disorder |
Substance use | Medication, caffeine, tobacco, alcohol; substance abuse history, pattern of use, and most recent use |
Lung disease | Dyspnea, cough, hemoptysis, wheezing, beta agonist use, corticosteroid use |
Infection | Fever, chills, previous endocarditis, previous rheumatic fever, recent illness |
Cardiac surgery | Surgical history |
Candidate for Cardioversion?