Atrial fibrillation in the older adult. Presentation and management issues.

Atrial fibrillation (AF) is a common cardiac arrhythmia in older adults and the most common cause of embolic stroke. Diagnosis of this illness is a challenge in that the older adult may be asymptomatic and/or may present with such atypical symptoms as a change in function, mood, or cognition. This challenge is demonstrated in three vignettes of older individuals who presented with acute onset AF. Nurses need to evaluate older patients for AF so that prompt treatment can be initiated. This proactive approach can have a major impact on preventing strokes and improving the quality of life in these individuals.

[1]  C. M. Hudak,et al.  Critical care nursing : a holistic approach , 1994 .

[2]  Palle Petersen,et al.  PLACEBO-CONTROLLED, RANDOMISED TRIAL OF WARFARIN AND ASPIRIN FOR PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN CHRONIC ATRIAL FIBRILLATION The Copenhagen AFASAK Study , 1989, The Lancet.

[3]  A Laupacis,et al.  Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. , 1995, Archives of internal medicine.

[4]  P. Wolf,et al.  Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. , 1991, Stroke.

[5]  P. Sloane,et al.  Clinical Efficacy and Outcome in the Diagnosis and Treatment of Low Back Pain , 1992, Neurology.

[6]  M. Monane,et al.  Pharmacotherapy: strategies to control drug costs in managed care. , 1998, Geriatrics.

[7]  J. Whittle,et al.  Is warfarin underused in the treatment of elderly persons with atrial fibrillation? , 1997, Archives of internal medicine.

[8]  S. Connolly,et al.  Stroke prevention in nonvalvular atrial fibrillation. , 1991, Annals of internal medicine.

[9]  R B D'Agostino,et al.  Secular trends in the prevalence of atrial fibrillation: The Framingham Study. , 1996, American heart journal.

[10]  J. Anderson,et al.  Acute treatment of atrial fibrillation and flutter. , 1996, The American journal of cardiology.

[11]  V. Salomaa,et al.  Atrial Fibrillation in Older Stroke Patients: Association with Recurrence and Mortality After First Ischemic Stroke , 1997, Journal of the American Geriatrics Society.

[12]  Z. J. Lipowski.  Letter: Psychosomatic medicine. , 1974, Lancet.

[13]  Emmett Kr,et al.  Nonspecific and atypical presentation of disease in the older patient. , 1998 .

[14]  Joseph T. DiPiro,et al.  Pharmacotherapy: A pathophysiologic approach , 1992 .