Specialists highlight the main diagnostic tools and current treatments for the condition.
Dr. María Ramos, president of the Puerto Rican Society of Cardiology and Dr. Antonio Orraca, member of the board of directors of the Puerto Rican Society of Cardiology. Photo: Medicine and Public Health Magazine. Fabiola Plaza.
During the Annual Convention of the Puerto Rican Society of CardiologyDr. María Ramos, president of the Society, and Dr. Antonio Orraca, member of the board of directors, addressed the main challenges of cardiovascular health in Puerto Rico and the diseases that have a high prevalence in the population.
One of them is the atrial fibrillation, an arrhythmia condition where the pulse is irregular. According to Dr. María Ramos, “it is a prevalent condition following 60 years of age, it is closely associated with advancing age and hypertension.”
The specialist points out that once it is identified, the patient should be treated immediately because the greatest risk of Afib is the production of clots in the heart that are the cause of ischemic cerebrovascular infarcts, which are mostly extremely debilitating for the patient.
In turn, it indicates that there are patients who do not present any symptoms or condition, however, the electrocardiogram shows the opposite: the atrial fibrillation. “The biggest complaint of patients is palpitationsan irregularity in the pulse that indicates that something is not right,” he added. Other symptoms can be: shortness of breath, intolerance to exercise and uncontrolled blood pressure.
The associated causes are mainly hypertension, although there are also others such as sleep apnea, obesity, excess alcohol, and certain drugs, in addition to those who consume a product derived from nicotine, not only smoking, but other substances or products. . “There are some stimulants, such as anabolic steroids, that might cause this type of arrhythmia“explained the specialist.
He also emphasizes that definitely the most serious consequence of Afib is ischemic stroke, “we know that following the age of 65, 5% of adults may suffer from Afib and following 80 years, 9%, this can have consequences such as cardiomyopathy and cause weakness of the heart in your pumping”.
For his part, Dr. Antonio Orraca explains that it is important to identify Afib in a patient, since if they have a high risk of developing a cerebrovascular accident as a consequence of this arrhythmia, the treatment with which they would start corresponds to anticoagulants.
“In asymptomatic patients, it is necessary to be aware of tools such as the electrocardiogram, sonogram, or events that the patient has had and suspects, to diagnose it,” stressed Orraca.
For Dr. Maria Ramos, Afib treatment is focused on reducing the patient’s symptoms, “let’s check the blood pressure first. Patients sometimes have tachycardias that reach 150 and 180 beats per minute, so the first thing at that time is to check the pulse.”
Due to the above, Dr. Ramos pointed out that there are treatments to return the patient’s rhythm to normal, either pharmacologically or electrically: electrical cardioversion and there are procedures performed by electrophysiologists such as cardiac ablation. Surgical procedures are also performed to correct this condition.“.
Regarding Afib and its relationship with the risk of ischemic attack, the specialist explained the treatment options that currently exist and the criteria used to determine them in each patient.
“There are several options, from pharmacotherapy aimed at slowing the pulse so that the patient is not symptomatic or even therapy that will resolve the arrhythmia to restore a normal rhythm of the heart. heart. Many times we can do cardioversions, and there are even other percutaneous interventions electrophysiologists do them and there are different modalities for this arrhythmia,” said Orraca.
It has also shown situations in which it is complex to control the patient’s heart rate, so they have to investigate possible additional causes that are causing the condition.
Regarding the treatment for Afib, Dr. Orraca emphasizes that the main thing is anticoagulants and regarding them he highlights the factor Xa inhibitors and vitamin K antagonists (AVK). “Truly, when we have the patient who is continuously or paroxysmally fibrillating, we usually know that he has a higher risk of developing a stroke than the general population.”
In addition, he explains that the specialists perform a calculation to determine the patient’s risk of forming a clot as a result of the arrhythmia and see if they are really going to benefit from anticoagulants, on that, they are taken into consideration factors such as age, lifestyle and other conditions that the patient suffers.
Dr. María Ramos explained that a healthy lifestyle is key to avoiding any medical condition, in addition to 80% of cardiovascular conditions might be preventableso, their recommendations are aimed at: exercising, avoiding a sedentary lifestyle, avoiding toxic habits, “not only the consumption of alcoholic beverages or drugs, but also the excess of junk food, high in sodium, sugars and saturated fats”.
Finally, Dr. Orraca indicated that in his medical practice he seeks to detect Afib in patients who have suffered cerebrovascular accidents, “in every patient who has a cerebrovascular accident, I approach and look for something that suggests that the patient might have paroxysmal Afib , according to the findings in the electrocardiogram, tests and risk factors. Afib is a very common cause of cerebrovascular events and we always have to keep it on the radar” he concluded.
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