San Francisco, CA
S U M M A R Y
DIARY: November 15, 2010 04:24 PM Monday;
VA called verify move EGD to Medical Center in San Francisco.
2...Atrial Fibrillation a-fib Causes Strokes Death
3...Strokes Death Atrial Fibrillation a-fib Causes
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7003 - ..
7004 - Summary/Objective
700501 - Follow up ref SDS 7 039G.
700505 - ..
7008 - Progress
700901 - This morning drove to the GI Clinic at the VA in Martinez to speak
700902 - with Kim, Jennifer, or Kendall to clarify and /or confirm Jennifer's
700903 - telephone message received Friday afternoon, seeming to say Doctor Lee
700904 - approved getting the EGD test at the GI Clinic at the VA Medical
700905 - Center in San Francisco, reported on 101112 0952, ref SDS 7 039G, and
700906 - in order to solve the driver problem presented in the letter to the
700907 - medical team on 101108 0929. ref SDS 4 6X3P
700909 - ..
700910 - The clinic was packed. There was a long line at the patient counter.
700911 - Did not stay, since it would have taken over an hour to get to the
700912 - counter, and the administrative issue would have taken medical staff
700913 - time away from patients who need care.
700915 - ..
700916 - In the afternoon, called VA Clinic Martinez to confirm telephone
700917 - message from Jennifer last Friday on 101112 0952. ref SDS 7 4R4U
700919 - ..
700920 - They closed at 1630, so missed them by 10 seconds.
Atrial Fibrillation A-fib Causes Strokes Death Television Commercial
A10401 - ..
A10402 - Atrial Fibrillation a-fib Causes Strokes Death
A10403 - Strokes Death Atrial Fibrillation a-fib Causes
A10405 - Just now there was an advertisement on television that seemed to say
A10406 - atrial fibrillation (a-fib) can cause strokes, so decided to follow up
A10407 - the letter asking about recent a-fib events, submitted on 101105 2223.
A10408 - ref SDS 3 755I, and follow up with another letter on 101110 1115.
A10409 - ref SDS 5 TT5G
A10411 - ..
A10412 - Research on the Internet does not list chest rocking back and forth as
A10413 - symptom of a-fib (see below, ref SDS 0 RD4L).
A10415 - ..
A10416 - Called Karen at the VA Cardiology Department Medical Center...
A10418 - 415 221 4810 ext 3181
A10420 - ..
A10421 - Got the number from her letter on 091006 0843. ref SDS 1 7M6R
A10423 - ..
A10424 - Left a message asking Karen to facilitate communication with the
A10425 - medical team on letters reporting possible a-fib events 1-year post
A10426 - cabg, initially on 101105 2223, ref SDS 3 755I, and follow up letter
A10427 - last week on 101110 1216. ref SDS 6 755I
A10429 - [On 101117 0530 met with VA Medical Center San Francisco
A10430 - Module #1; Neil has left cardiothoriacic surgery team;
A10431 - Ramone advised letters on 101105, and follow up 101110,
A10432 - were forwarded to Michael Byrd in General Surgery on 3rd
A10433 - Floor. ref SDS 8 PPWU
A10435 - ..
A10436 - Research on the Internet found...
A10438 - 1. Emedicinehealth
A10440 - http://www.emedicinehealth.com/atrial_fibrillation/article_em.htm#Atrial%20Fibrillation%20Overview
A10442 - ..
A10443 - Atrial Fibrillation Overview
A10445 - ..
A10446 - 1. Atrial fibrillation describes an irregular and often rapid
A10447 - heart rhythm. The irregular rhythm, or arrhythmia...
A10449 - http://www.emedicinehealth.com/script/main/art.asp?articlekey=2328
A10451 - ...results from abnormal electrical impulses in the heart. The irregularity
A10452 - can be continuous, or it can come and go.
A10454 - ..
A10455 - 2. Normal heart contractions begin as an electrical impulse in the right atrium.
A10456 - This impulse comes from an area of the atrium called the sinoatrial (SA) or
A10457 - sinus node, the "natural pacemaker."
A10459 - http://www.emedicinehealth.com/script/main/art.asp?articlekey=19483
A10462 - ..
A10463 - 1. As the impulse travels through the atrium, it produces
A10464 - a wave of muscle contractions. This causes the atria
A10465 - to contract.
A10467 - ..
A10468 - 2. The impulse reaches the atrioventricular (AV) node in
A10469 - the muscle wall between the 2 ventricles. There, it
A10470 - pauses, giving blood from the atria time to enter the
A10471 - ventricles.
A10473 - ..
A10474 - 3. The impulse then continues into the ventricles, causing
A10475 - ventricular contraction that pushes the blood out of
A10476 - the heart, completing a single heartbeat.
A10478 - ..
A10479 - 3. In a person with a normal heart rate and rhythm the heart
A10480 - beats 50-100 times per minute.
A10482 - 1. If the heart beats more than 100 times per minute, the
A10483 - heart rate is considered fast (tachycardia).
A10485 - http://www.emedicinehealth.com/script/main/art.asp?articlekey=5698
A10487 - ..
A10488 - 2. If the heart beats less than 50 times per minute, the
A10489 - heart rate is considered slow (bradycardia).
A10491 - http://www.emedicinehealth.com/script/main/art.asp?articlekey=2515
A10493 - ..
A10494 - 4. In atrial fibrillation, multiple impulses travel through the atria at the same
A10495 - time.
A10497 - 1. Instead of a coordinated contraction, the atrial
A10498 - contractions are irregular, disorganized, chaotic, and
A10499 - very rapid. The atria may contract at a rate of
A10500 - 400-600 per minute.
A10502 - ..
A10503 - 2. These irregular impulses reach the AV node in rapid
A10504 - succession, but not all of them make it past the AV
A10505 - node. Therefore, the ventricles beat slower, often at
A10506 - rates of 110-180 beats per minute in an irregular
A10507 - rhythm.
A10509 - ..
A10510 - 3. The resulting rapid, irregular heartbeat causes an
A10511 - irregular pulse and sometimes a sensation of fluttering
A10512 - in the chest.
A10514 - ..
A10515 - 5. Atrial fibrillation can occur in several different patterns.
A10517 - 1. Intermittent (paroxysmal): The heart develops atrial
A10518 - fibrillation and typically converts back again
A10519 - spontaneously to normal (sinus) rhythm. The episodes
A10520 - may last anywhere from seconds to days.
A10522 - ..
A10523 - 2. Persistent: Atrial fibrillation occurs in episodes, but
A10524 - the arrhythmia does not convert back to sinus rhythm
A10525 - spontaneously. Medical treatment is required to end
A10526 - the episode.
A10528 - ..
A10529 - 3. Permanent: The heart is always in atrial fibrillation.
A10530 - Conversion back to sinus rhythm either is not possible
A10531 - or is deemed not appropriate for medical reasons.
A10533 - ..
A10534 - 6. Atrial fibrillation, often called A Fib, is a very common heart rhythm
A10535 - disorder.
A10537 - 1. It affects about 1% of the population, mostly people
A10538 - older than 50 years. This amounts to more than 2
A10539 - million people.
A10541 - ..
A10542 - 2. The risk of developing atrial fibrillation increases as
A10543 - we get older. About 5% of people older than 80 years
A10544 - have atrial fibrillation.
A10546 - ..
A10547 - 7. For many people, atrial fibrillation may cause symptoms but
A10548 - does no harm.
A10550 - 1. Complications can arise, but appropriate treatment
A10551 - reduces these risks.
A10553 - 2. If treated properly, atrial fibrillation rarely causes
A10554 - serious or life-threatening problems.
A10556 - ..
A10557 - Symptoms....
A10559 - 1. Symptoms of atrial fibrillation vary from person to
A10560 - person.
A10562 - 1. A number of people have no symptoms.
A10564 - ..
A10565 - 2. The most common symptom in people with intermittent
A10566 - atrial fibrillation is palpitations...
A10568 - http://www.emedicinehealth.com/script/main/art.asp?articlekey=58684
A10570 - ...a sensation of rapid or irregular heartbeat. This
A10571 - may make some people very anxious. Many people also
A10572 - describe an irregular fluttering sensation in their
A10573 - chests.
A10575 - ..
A10576 - 3. Some become light-headed or faint.
A10578 - ..
A10579 - 4. Other symptoms include weakness, lack of energy or
A10580 - shortness of breath with effort, and chest pain.
A10582 - ..
A10583 - Causes A-fib....
A10585 - ..
A10586 - Atrial fibrillation frequently occurs after cardiothoracic
A10587 - (open heart) surgery, but often resolves in a few days.
A10589 - ..
A10590 - This was experience on 091024, 2-days after heart surgery, ref SDS 2
A10591 - HR7G; evident physicial symptom however was upper body chest rocking
A10592 - left and right (swaying). 091024 0600, ref SDS 2 HR8O
A10594 - ..
A10595 - 2. Wikipedia
A10597 - http://en.wikipedia.org/wiki/Atrial_fibrillation
A10599 - ..
A10600 - Atrial fibrillation is often asymptomatic and is not in itself
A10601 - generally life-threatening, but it may result in palpitations,
A10602 - fainting, chest pain, or congestive heart failure. People with
A10603 - AF usually have a significantly increased risk of stroke (up to
A10604 - 7 times that of the general population). Stroke risk increases
A10605 - during AF because blood may pool and form clots in the poorly
A10606 - contracting atria and especially in the left atrial appendage
A10607 - (LAA). The level of increased risk of stroke depends on the
A10608 - number of additional risk factors. If a person with AF has
A10609 - none, the risk of stroke is similar to that of the general
A10610 - population. However, many people with AF do have additional
A10611 - risk factors and AF is a leading cause of stroke.
A10613 - ..
A10614 - Symptoms...
A10616 - ..
A10617 - Atrial fibrillation is usually accompanied by symptoms related
A10618 - to a rapid heart rate. Rapid and irregular heart rates may be
A10619 - perceived as palpitations, exercise intolerance, and
A10620 - occasionally produce angina (if the rate is faster and puts the
A10621 - heart under strain) and congestive symptoms of shortness of
A10622 - breath or edema. Sometimes the arrhythmia will be identified
A10623 - only with the onset of a stroke or a transient ischemic attack
A10624 - (TIA). It is not uncommon for a patient to first become aware
A10625 - of AF from a routine physical examination or ECG, as it may be
A10626 - asymptomatic in many cases.
A10628 - ..
A10629 - As most cases of atrial fibrillation are secondary to other
A10630 - medical problems, the presence of chest pain or angina,
A10631 - symptoms of hyperthyroidism (an overactive thyroid gland) such
A10632 - as weight loss and diarrhea, and symptoms suggestive of lung
A10633 - disease would indicate an underlying cause. A previous history
A10634 - of stroke or TIA, as well as hypertension (high blood
A10635 - pressure), diabetes, heart failure and rheumatic fever, may
A10636 - indicate whether someone with AF is at a higher risk of
A10637 - complications