atrial-fibrilation

Alcohol-induced dilated cardiomyopathy

Note the enlarged ventricular chambers - the increased size causes the appearance of thinned ventricular walls. Assumption that there is decreased musculature in heart walls can cause incorrect diagnosis of cause-of-death.

Dilated cardiomyopathy can cause systolic dysfunction and atrial fibrilation, as well as being a source of thromboembolism.

kvestori  asked:

I have a question about basic medical care in a post-apocalyptic / zombie apocalypse setting. What kind of things would be the most important to acquire? And what kind of substitutes could you use, like vodka for cleaning wounds. You said earlier that asthmatics would be hard hit, I assume other chronic illnesses too, diabetics to name one? (Thank you for the blog! It's so great.)

Hey there! Yeah, asthmatics are in trouble, as is anyone with significant allergies, including anaphylaxis. Type I diabetics will die very quickly after the event, within a few weeks if they don’t have their meds. Type II diabetics will survive a lot longer. For one, the apocalypse will probably require them to get a lot of physical exercise; for another, diet may or may not improve if they’re eating out of farms (after the supplies of carbs run out).

People with thyroid disorders and atrial fibrillation are in trouble too, the first because people may be unable to control their heart rates and metabolism, the second because they’re now going to be prone to throwing clots, which can cause strokes. HIV+ people might last a few months, though it might be less.

Generally, any event involving mass die-offs will weed out the young, the old, the sick and the weak.

As to what people would hoard? Individuals will generally hoard anything they or their family members will need. If I were raiding a hospital in the first few days, I would probably hit up stuff like analgesics (painkillers) of all types including over-the-counter stuff, antihistamines, adrenaline (for allergic reactions), and a good set of broad-spectrum antibiotics. Insulin; I personally don’t need it but it would be invaluable as a trade. Generally I would avoid anything that someone would need every day for years; realistically, the stock on hand won’t be enough to keep them alive forever.

If I had the carrying capacity, I would take a WHOLE LOT of IV fluids, start kits, needles, bandages, scalpels, iodine, a handheld ultrasound (if they’re there and I have reason to think I can get electricity)…. hmm. That’s all I can think of off the top of my head, but I’m sure there’s more; if I think of something I’ll reblog this with the additions.

Thanks for the ask! xoxo, Aunt Scripty.

Babe: every time I see you, my heart skips a beat

Roe: how often does that happen?

Roe: do you feel heaviness in the chest? do headaches come and go? does the pain reach the neck?

Babe: Gene, I -

Roe: how about shortness of breath?

Babe: well, you certainly take my breath away too, but that’s not the-

Roe: dear God, I need to take you to the hospital

Roe: this could be atrial fibrilation-

Babe: Gene

Roe: …or premature ventricular contractions-

Babe: Gene

Roe: -…i don’t know your family history on heart diseases but you should call your father and-

Babe: EUGENE LISTEN TO ME

Roe: -…I need to take blood tests as well as cardiogram- 

Babe: oh my god

First Do No Harm.

As doctors, we can’t help patients who won’t help themselves. Like my patient, Maisy Leland. She has a condition known as atrial fibrillation, meaning her heart rhythms are irregular in a way that could induce blood clots. Left untreated, she could stroke out at any second. That’s why I’ve prescribed her with warfarin, a blood thinner that makes her less prone to clotting.

The problem is, Maisy Leland is what we call a non-compliant patient. It doesn’t matter what wonder drug she’s prescribed if she won’t take her medications regularly. She won’t admit to it, but her alarmingly low INR tells the whole story.

Her husband, a gorilla of a man, brought her to the appointment, mumbling about his time wasted. “Well doc, tell the silly bitch what’s wrong with her.” He barked a laugh, his grip firmly on her shoulder. Maisy Leland said nothing to her husband’s silent gloat of how he could get away with hurting her with no bruises.

“Ms Leland, as your physician I am concerned. Your bloodwork hasn’t shown any improvement. If warfarin doesn’t work, we’ll have to consider more expensive options.”

“Who’s gonna pay for that?” Her husband demanded. “Maisy, you stupid bitch! Haven’t you cost me enough money?”

“Do you remember what we’ve discussed last time, Ms Leland?”

Maisy Leland’s pale lips went thin. “Of course. You accused me of not taking my meds.”

“Accuse is a strong word.”

“I’m not senile,” she said as her husband scoffed, “I know how well my medication is supposed to work. I assure you, I never miss a dose.” She looked at her husband. “I’m a very patient woman, doctor. I know it takes time to see full effect.”

“Yes, but for warfarin, we’re talking two to four weeks at most. We’ve been incrementing your warfarin dose for months now, but your readings haven’t shown a tad of improvement. In fact, I’ve never seen even a grown man take this much warfarin without bleeding out sooner or later. But going by your INR, it’s like you’ve never taken a single pill to begin with.”

Maisy Leland’s lips practically lost dimension. “I wouldn’t worry about it, doctor. Like I said, I’m a very patient woman.”

I sighed. No doctor in the world can help a patient who won’t help themselves. “In that case, we’ll try upping the dose again. If your INR shows no improvement in two weeks, we’ll talk alternatives, okay?”

She agreed.

“Goddamn, Maisy,” her husband snarled, “your messed up heart is gonna bleed me dry one day.”

As they let themselves out, Maisy Leland’s husband turned to me. “And doc, those vitamins you had Maisy get me? You’d better make damn well sure it’s covered by my insurance this time.”

I met Maisy Leland’s petrified gaze. Well, damn. She’s a very patient woman, alright.

“Of course,” I finally said, “I’ll see to it.”

As doctors, we can’t help patients who won’t help themselves. That’s why we’ll do everything to help those who do.

First Do No Harm

Estimated reading time: Less that or equal to 5 minutes. Story Source. This story is not necessarily scary. 

As doctors, we can’t help patients who won’t help themselves. Like my patient, Maisy Leland. She has a condition known as atrial fibrillation, meaning her heart rhythms are irregular in a way that could induce blood clots. Left untreated, she could stroke out at any second. That’s why I’ve prescribed her with warfarin, a blood thinner that makes her less prone to clotting.

Keep reading

The Signs as Cardiac Rhythms
  • Aries: Normal Sinus Rhythm
  • Taurus: Ventricular fibrillation
  • Gemini: Ventricular tachycardia
  • Cancer: Atrial flutter
  • Leo: Torsades des Pointes
  • Virgo: Asystole
  • Libra: Junctional tachycardia
  • Scorpio: Wandering Atrial Pacemaker
  • Sagittarius: Sinus arrest
  • Capricorn: Bradycardia
  • Aquarius: 3rd degree AV block
  • Pisces: Atrial fibrillation

Medical Mnemonics// Causes of atrial fibrillation (characterised by absent P waves on an ECG) can be remembered using the mnemonic PIRATES.

If you like my posts, please consider taking the time to visit toho-medblr.com on your desktop and clicking on the ads, I’ve recently installed google adsense. It feels a bit cheeky, but means you’ll be seeing more original content on this blog.

First Do No Harm

As doctors, we can’t help patients who won’t help themselves. Like my patient, Maisy Leland. She has a condition known as atrial fibrillation, meaning her heart rhythms are irregular in a way that could induce blood clots. Left untreated, she could stroke out at any second. That’s why I’ve prescribed her with warfarin, a blood thinner that makes her less prone to clotting.

The problem is, Maisy Leland is what we call a non-compliant patient. It doesn’t matter what wonder drug she’s prescribed if she won’t take her medications regularly. She won’t admit to it, but her alarmingly low INR tells the whole story.

Her husband, a gorilla of a man, brought her to the appointment, mumbling about his time wasted. “Well doc, tell the silly bitch what’s wrong with her.” He barked a laugh, his grip firmly on her shoulder. Maisy Leland said nothing to her husband’s silent gloat of how he could get away with hurting her with no bruises.

“Ms Leland, as your physician I am concerned. Your bloodwork hasn’t shown any improvement. If warfarin doesn’t work, we’ll have to consider more expensive options.”

“Who’s gonna pay for that?” Her husband demanded. “Maisy, you stupid bitch! Haven’t you cost me enough money?”

“Do you remember what we’ve discussed last time, Ms Leland?”

Maisy Leland’s pale lips went thin. “Of course. You accused me of not taking my meds.”

“Accuse is a strong word.”

“I’m not senile,” she said as her husband scoffed, “I know how well my medication is supposed to work. I assure you, I never miss a dose.” She looked at her husband. “I’m a very patient woman, doctor. I know it takes time to see full effect.”

“Yes, but for warfarin, we’re talking two to four weeks at most. We’ve been incrementing your warfarin dose for months now, but your readings haven’t shown a tad of improvement. In fact, I’ve never seen even a grown man take this much warfarin without bleeding out sooner or later. But going by your INR, it’s like you’ve never taken a single pill to begin with.”

Maisy Leland’s lips practically lost dimension. “I wouldn’t worry about it, doctor. Like I said, I’m a very patient woman.”

I sighed. No doctor in the world can help a patient who won’t help themselves. “In that case, we’ll try upping the dose again. If your INR shows no improvement in two weeks, we’ll talk alternatives, okay?”

She agreed.

“Goddamn, Maisy,” her husband snarled, “your messed up heart is gonna bleed me dry one day.”

As they let themselves out, Maisy Leland’s husband turned to me. “And doc, those vitamins you had Maisy get me? You’d better make damn well sure it’s covered by my insurance this time.”

I met Maisy Leland’s petrified gaze. Well, damn. She’s a very patient woman, alright.

“Of course,” I finally said, “I’ll see to it.”

As doctors, we can’t help patients who won’t help themselves. That’s why we’ll do everything to help those who do.

Behind the Medic: I don't usually get updates from my urgent care patients if everything went well...
  • Cranquis Boys (running amok in the grocery store): I want this kind of pasta! Can we get some applesauce?
  • Woman (walks past, then double-takes): Oh, you're Dr. Cranquis! You don't remember me, but 3 years ago... [insert story here]... and I just wanted to thank you for how you figured out I was having atrial fibrillation, my cardiologist said I'm doing great now!
  • Cranquis (awkwardly humble): Oh well, sure, my pleasure, thanks for the update!
  • Cranquis Boys: Dad why did that lady want to talk to you?
  • Cranquis: Well, I helped her a while ago and --
  • Woman #2 (walks past, double-take): Oh hello, aren't you Dr. Cranquis?
  • Cranquis: Y-yes?
  • Woman #2: It's so nice to see you! Do you remember, you stitched up my finger after I cut myself cooking the Thanksgiving meal last year?
  • Cranquis (no I don't): Oh sure! No accidents this year?
  • Woman #2: Nope, I'm doing fine, thank you again!
  • Cranquis: Oh well, sure, my pleasure.
  • Cranquis Boys: Dad how come everybody knows you in the store today?
  • Cranquis: I have no idea, but I'll be wearing this paper bag over my head for the duration. Go find the applesauce.
Hearts all around

I’m rewatching the episode right now but I needed to pause to talk about this thing.

Harold had just had heart replacement(correction here) surgery, Arthur had “a broken heart” and they assumed Mildred would be the next one because of her atrial fibrilation. What all those have in common is that their vulnerability was their heart, so why was Dean vulnerable then?

Because of matters of the heart of course. There is an extraneous force calling for his heart, making him feel an attraction that scares him and that he doesn’t want. And when he confided this on someone close to his heart, he was told that it may be a good thing they could use to their advantage, instead of receiving the support and understanding he expected. There’s also the fact that unbeknownst to him he just confesed all his intimate fears to an enemy who will no doubt take advantage of that knowledge and unscrupulously use it to further his own goals. There is our Dean’s very vulnerable heart at the moment.

It’s also interesting to see how he was paralleled to the other three vulnerable hearted people this episode.

Stealing Harold’s viagra (just like he had stolen it from other people before) is yet another symbolic nod to Dean getting old. When Dean says “Maybe we oughta make a reservation” when they’re arriving to the retirement home, the camera very blatantly pans down to focus on the picture of the old happy couple staring out at the sea.

Arthur’s broken heart is due to his emoji-loving wife having just left him, and not returning his calls. He also would like to have sent her the heart, tell her how he really feels, but he can’t help being rougher than that to her. Now, I don’t know why, but this kinda reminds me of someone who has just left and isn’t giving any signs of life, and who Dean has some trouble showing his appreciation to¿? I’m just saying, maybe Cas said yes because Dean keeps sending poop emojis when actually he meant to send the heart.

[gif source]

And then we have Mildred, who told him to follow his heart, and was able to see that there’s someone else he’s pining for.

Now, knowing all those very interesting things about Dean’s heart, I would say his vulnerablity is as much about Amara as it is about his pining for Cas and his worry for whatever is going on with him, and even in a foreboding sense, the fact that he exposed his heart to a dangerous enemy and he doesn’t even know it yet.

I never really appreciated the life I was given until last night while caring for a geriatric patient who was undergoing atrial fibrilation. He was straining himself with every breath and with every breath came slight chest pains. He was tachycardic and there wasn’t much I could do for him as an EMT who’s still in training. To be honest there isn’t much a professional EMT can do in this case other than supply him with oxygen, which we did through the nasal cannula he was already receiving o2 from. I stood back and watched the paramedic and his assigned EMT assess the patient. As the two collected information about past medical history, medications, allergies, last oral intake etc. I couldn’t help but to observe their living conditions. As an EMT student we are taught to take note of their surroundings especially if we are dealing with the elderly. I spotted no lighting in this man’s room. We were holding flashlights. The walls were falling apart, the wooded construction of the home was clearly visible, floors were creaking, the stairs were unstable, and the poor man was pretty much living in the left over space of the kitchen. This wwas a home for not just him but for three other people. I mean I’m thankful that it was as organized as could be, but actually seeing this kind of slum was almost negatively breath taking. I was at a loss for words completely. Just shocked. I’m always hearing news about the millions who fall under the poverty line but I had no idea that what the reporters always talk about happens not even an hour away from my area. I mean this just struck a nerve. I don’t even want to be in the medical field for the money. I want to be in it to help those who are iin need of medical assistance. This is probably very naive of me to say but I would have loved to pay for his medical bill. He had already been in the hospital that day and not even 24 hours later did he have to go back to the ER. Id want to pay for Not.only him but anyone who needs financial aid. This is a wild dream i have. I wont be making nearly wnough money to pay for everyones medical bills but… Its so sad to see people live in these kinds of conditions when I live such a wonderful life. some may say they did it to themselves, and that statement isn’t false but shouldn’t it also be our duty to help those in need and not degrade them for not trying hard enough in life? What I took from this experience was how happy and content this family seemed. They literally appreciate life so much more than I do on any given day and it was encouraging and eye opening to see what happiness is all about, what it *should* be about.

Heart flutter

Painful. Not happy happy heart flutter. Been happening the past two days and I keep dreaming that I’m unable to breath or someone is squeezing me reaaaaaaly hard. Ouch >.<. They do say that sleeping on your left side can cause some pressure on your chest and restrict blood flow thus leading to bad dreams. Hmmmm. But in waking life it’s a little freaky. As if any moment I’ll become an old woman and ahhh ohhhh owwww ahhh. passes out >.<