Medical Emergencies · patient case question
Atrial fibrillation in this patient most predisposes him to which emergency?
Patient case: Man in exercise clothing requesting a rapid appointment
Patient: Adult male
Chief complaint: Arrives in tennis and jogging clothes, asking to be seen quickly so he can continue his exercise routine.
Background: Atrial fibrillation, with episodes provoked by stress and by exertion.
Current findings: Currently asymptomatic and haemodynamically stable.
Show answer and explanation
Correct answer: A. Thromboembolic stroke
- A. CORRECT. In atrial fibrillation the atria quiver rather than contract, blood stagnates in the left atrial appendage and thrombus forms. Embolisation of that thrombus to the cerebral circulation makes STROKE the defining risk — which is precisely why these patients are anticoagulated, and why their anticoagulation must be respected rather than casually interrupted for dental care.
- B. Hypoglycaemia is unrelated.
- C. Malignant hyperthermia is a pharmacogenetic reaction to volatile anaesthetics and succinylcholine.
- D. Seizure is not a consequence of atrial fibrillation, although a large embolic stroke can subsequently cause seizures.
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