Heart -General

[Marina46]

Hello,

What is arterial fibrillation? What causes it?When should it be treated?Why are women treated differently then men when presenting with symptoms of a heart attack? And Why are women more often then men brushed off or diagnosed as having an anxiety attack? Furthermore, why are women’s risk factors treated less aggressively when women are more likely to die from a first heart attack then man is?    

Thanks,
Marina

[Cleveland Clinic]

marina,

those are a lot of difficult questions, some are very important and not with great answers.

What is arterial fibrillation?

There are 2 chambers of the heart and 2 sides of the heart.  The upper chambers of the heart are called the atria and pump blood to the lower chambers the ventricles.  The electricity in the heart causes the atria to beat slightly before the ventricles.  Sometimes this wiring goes awry and instead of a single electical impulse causing the atrium to beat in unison there is a chaotic electrical signal which causes the atria to fibrillate.  Blood then just flows through the atrium without the assisatnce of the atrial beat to help fill the ventricles.  

What causes it?

A lot of different things.  Stress, genes, structural changes to the atria from hypertension and valve problems, and other factors yet to be determined.

When should it be treated?

This is a difficult question.  Treatment evaluation should always be considered.  The treatment options involve 3 main categories  
1) Cardioversion vs. Medical therapy,  2) Maintenance of sinus rhythm with medicines vs ablation and 3) anticoagulation for stroke prevention.  The most category that should always be addressed even in asymptomatic patients is the last one.  The others depend on symptoms and comorbidities.

Why are women treated differently then men when presenting with symptoms of a heart attack? Why are women more often then men brushed off or diagnosed as having an anxiety attack?


Until recently is wasnt as well recognized that women often present with symptoms different from men.  Some of this has to do with the fact that a lot of the original trials contained a larger majority of men thus skewing what was reported for symptoms and demographics of what was considered normal.  Hopefully, the recent awareness programs like the AHA/ACC Red Dress compaign will increase physician awareness of this fact.

Furthermore, why are women’s risk factors treated less aggressively when women are more likely to die from a first heart attack then man is?

There is no good answer here. I tend to think that overall, risk facotrs are not well addressed in a lot of patients both men and women at risk for cardiovascular disease.  Additionally, we are in the process of developing a special program designed for women's cardiovascular health that will be an integral part of the new Heart Center at the Cleveland Clinic.  Perhaps programs such as these will bring greater awareness for those at risk.

good luck

[Barbarella]

Because its a "Man's world".  JUST KIDDING!!  :) :)

[~*CaMeO*~]

Just couldn't resist, could you?   LOL

[Barbarella]

:) :) :) :) :) :) : )

[Marina46]

bkj or anyone who wants to answer,

Does severity, frequency, or cause of the arterial fibrillation impact treatment option in anyway, if so how? Also, is anticoagulant therapy indicated in all individuals who have  Arterial fibrillation? Can beta-blockers control heart rate enough to prevent symptoms?

Thanks

Marina

[worriedsilly]

I am assuming your a nurse.  Omg isnt the drs advice enough.  You are not speaking from experience and trying to sound like the dr yourself.  Gag me.

[Barbarella]

I agree, didn't the doctor above respond in a lenghthy and great detailed message?

[Marina46]

OrthoRN,

I appreciate the additional information,thank you.

Marina

[dreamboat]

Hey this is about a book that you mentioned that helped you with anxiety back in January.Could you please tell me what it is.
Thanks!

[Barbarella]

Actually its four books by Dr. Claire Weeks.  "Hope and Help for your Nerves", Peace from Nervous Suffering, More Help for Your Nerves" and "Agorophobia"  (agorophobia in case you don't know is when people are so afraid to leave their home because they are so afraid of having a panic attack while outside of the home)

You can order these books on amazon.com or go to the bookstores at the malls if they don't have them on their shelves they will order them for you.

As I said before NOTHING has helped me i.e. meds, different kinds of therapies until I read her books.  You don't have to get all four, in my case the very first one I read "Hope and Help for your Nerves" has helped me tremendously I just wanted to read her other books too.  She dealt with people just like me (anxiety and panic attacks) the therapists on the other hand I've seen in the past had absolutely NO clue.

Good Luck!

[jkf]

Just wanted to add my two cents regarding those books.  When I was in my 20's (now 40) I had pvc's (still do) that led to panic attacks.  I was so afraid to leave the house.  I did but I was miserable.  I found her books ad they saved me.  I still have the same copies stuck up in my closet.  Torn pages, highlighted areas and all.  They are the best investment anyone could make.  She taught me how to not panic over the heart skips.  I learned to relax and in turn my pvc's were less severe.  It is such a vicious cycle to overcome and those books WORK!!!!

[Barbarella]

I too still have her books with torn pages and "aged" pages and covers.  I still at times get them out after 30 yrs, and I still read over certain lines and paragraphs when I feel there is the need.

[Barbarella]

P.S. This lady has helped so many people including me.  I have absolutely no use for the Therapists I have seen.  I had them sitting in front of me "yawning" another one did her "filing" while she pretended to listen to me.  Another one made me sit across a chair and I had to "yell" at the chair "you will not do this to me any longer you will get rid of my panic attacks".  At the next visit she used to say "are the panic attacks gone"?? I saw her three times and that was the end of that.  Another one said "all you have to do is take a deep long breath when you feel the panic attack coming".  Yeah right, NONE of them NEVER has been through a panic attack and they have no clue. If deep breathing would've taken care of it I'd not have to spent all that money on the Therapaists.  One of them asked me with a "rolling of the eyes" attitude "what exactly ARE YOU afraid of"? No clue.  And that is fine, but don't take on patients who suffer from panic attacks when you have absolutely NO clue how to help them.  BUT Dr. Weeks did and I am forever grateful to her.

[jkf]

Thankfully I chose to read the books BEFORE seeing a therapist!
I had a bad episode of pvc's a month or so ago.  I was getting about 10/minute in lieu of my usual 10 in 24 hours.  I could tell the panic was rearing it's ugly head.  I pulled down her books read the specific pages I highlighted years ago and withing 12 hours the pvc's had stopped.  THAT to me is amazing, and it just goes to show that the fear of the pvc's makes them so much worse.  If you focus on them, they will come....:)
Jodie

[Emmaj]

Hi Marina,

As I understand it, some people go for years in afib, and they are okay, but those people have a lousy av node that doesn't allow many of the afib signals to get to the ventricles. If you are like me, and have afib and a healthy av node, then the afib really should be controlled, especially if it is frequent or constant -- because if it is frequent or constant, it could cause your heart to fail -- the left ventricle just can't keep up with the afib. When this happened to me, I could see the blood backing up in the veins of my neck! Sometimes cardioversion will stop it. But the more cardioversions, the less well your body responds. So, I take a betablocker, Betapace. No one wanted me to take Amiodarone because of the long=term side effects. I couldn't take Tykosin because I have a long QT. I was taking Toprol 25mg, but it got me into trouble, wasn't enough to stop the afib, but you can pretty much tell when a med isn't working for afib... Best of luck!!!

[Emmaj]

Me again! I was wondering what OrthRN wrote, and then I realized that post had been removed! I have never seen that before!!! Anyway, I hope I didn't repeat anything. One thing I am wondering about the bkg's response to you is re ablation for afib. I understand it is generally not too effective for afib. I think the Maze procedure is what they do... and it just hasn't panned out too well for the most part... but maybe there is something else?? I do take Coumadin, and it really isn't too bad. I would love not too, but... oh well. Take care -- Oh, I am wondering this about women and heart disease... maybe because we are more used to pain being normal (periods, childbirth) than men and because we tend to set aside our needs for our families, we don't tune in as fast when something is wrong?? Anyway, take care, E.

[Lexicon154]

"There are 2 chambers of the heart and 2 sides of the heart"

As we know, there are FOUR chambers of the heart, not two.  Is this a typo, or did you mean to say that there are 2 chambers on each of the 2 sides of the heart?

Thank you.

[Emmaj]

Lexicon, the dr just made a typo. Who doesn't?? :} The dr's answer was good, I think. Marina, here is another comment... when I had afib just occasionally (even though I was on Toprol 25 mg), my dr wasn't worried about it because I was on Coumadin. If a person has any afib, he or she should relly be on Coumadin. It was just when my afib went haywire, I had to go for the more powerful anti-arrhythmia med. Also, I think most drs would try meds over cardioversion... and cardioversion if meds don't work. There is some risk to cardioversion. I had it once, and it wasn't bad, but you have to be under anesthesia for a while. E.

[tickertock]

the doc clarified exactly what he meant, the upper chambers and lower chambers, left and right atrium and right and left ventricle, 2 chambers and each side of the heart the upper and lower chamber equals = 4, BIG DEAL. couldn't be explained any better or clearer as far as I am concerned.

[worriedsilly]

Lexi thats so cool calling the dr out like that.  Geesh you know what he meant.  Some people here just really do think they are smarter than the drs.  Get a life.

[NBCT]

Mature responses only please.

[Stelladallas]

I too have experienced AF resulting from diastolic dysfunction and more recently diagnosed with sick sinus syndrome.  I now have a dual chamber pacemaker, meds., and feel great.  I was very lucky that my regular physician always took me seriously and I think it is because he knew me very well.  On several occasions, I had to go to the emergency room and never was I treated as a hysterical woman.  I remember going to a wonderful workshop yrs. ago and the physician there said that Drs. often take men more seriously because like most of us, they are more visual and so when men present to the Dr. they actually look sick while many women will say they are sick and be very well groomed with all makeup intact. That's me! In fact, a couple of Drs. told me that I looked very well, but as they examined me and read my history, they knew better.  I must say that I too tended to minimize my problems because I did not want to be sick.

[Otunba2000]

hello sir,
i am a nigeria patient with a severe chest pain.
I have been experience this pain over some time, precisely
6months, sometime it's started it comes with fever with pains below my right abdomen. This pain alway affecting most time i have a cough,hil-cough,yawning and any muscular stretching.

I do spatum test no sign of TB and x-ray only a littlr complain pls help me and i will forward the rest information if neccsary.

Tunde
Lagos