Atrial fibrillation

doi:10.1136/bmj.39252.659016.94

Published 24 July 2008, doi:10.1136/bmj.39252.659016.94
Cite this as: BMJ 2008;337:a475

Practice

10-Minute Consultation

Atrial fibrillation

Kathryn E Griffith, general practitioner¹, Maurice Pye, consultant cardiologist²

¹ University Health Centre, York University, York YO10 5DD, ² York Hospital, York

Correspondence to: K Griffith kathryn.griffith@york.nhs.uk

The first 150 words of the full text of this article appear below.

A 63 year old man sees your practice nurse for a routine bloodpressure check. He has had hypertension for five years and istaking ramipril 10 mg, bendroflumethiazide 2.5 mg, and atenolol25 mg daily. He has no past history of ischaemic heart disease,stroke, or diabetes. The nurse’s electronic sphygmomanometeris unable to produce a recording, and she asks for your advice.You find his pulse to be intermittently irregular.

What issues you should cover

Atrial fibrillation is a recognised cause of error in bloodpressure measurement. When atrial fibrillation is an incidentalfinding and thus asymptomatic, it may be difficult to decidewhether it is paroxysmal, persistent, or permanent.
It isimportant to reach a diagnosis and arrange electrocardiographyas soon as possible and to confirm that he has not had an embolicevent, particularly a transient ischaemic attack (TIA) withsudden onset of reversible neurological deficit.
Atrial fibrillationcan result in . . . [Full text of this article]