Auricular Fibrillation Treatment


Categories: Uncategorized
Sources: Disturbances Of The Heart

The condition may be stopped by relieving the heart and circulation

of all possible toxins and irritants, and by the administration of

digitalis. One attack is frequently followed by others, perhaps of

longer duration. Occasionally, however, the patient may be observed

for many years without the condition again being present. If the

pulse, in spite of treatment, is permanently irregular, and

auricular insufficiency is permanent, the patient is of course in

danger of cardiac failure; but still he may live for years and die

of some other cause than heart failure. The prognosis is better when

the pulse is not rapid--below a hundred. This shows that the

ventricles are not much excited and do not tend to wear themselves

out.



Any treatment which lowers the heart rate is of advantage, such as

the stopping of tea and coffee, and the administration of digitalis,

together with rest and quiet.



While large doses of digitalis are advised, and large doses are

given as soon as a patient with auricular fibrillation comes under

treatment, such large dosage is dangerous practice. Many patients

may be cured or may survive fluidram doses of the official tincture,

but such large doses should never be used unless it is decided,

after consultation, that, though dangerous, it may be a life-saving

treatment.



If a patient has not been receiving digitalis, it is best to begin

with a small close and gradually increase the dosage, rather than to

give the heart a sudden shock from an enormous dose of digitalis.

The preparation selected must be the best obtainable, but the exact

dosage of any preparation can be determined only by its effect, as

all preparations of digitalis deteriorate sooner or later. It is

well to administer digitalis at first three times a day, then as

soon as its action is thoroughly established, reduce to twice a day,

and later to once a day, in such dosage as is needed to make a

profound impression on the heart. The first dose may be from 5 to 10

drops, and the dosage may be increased by 5 drops at each dose,

until improvement is obtained. If the patient is in a momentary

serious condition and liable to die of heart failure, it is doubtful

if digitalis pushed at that time will be of benefit. On the other

hand, if, after consultation, it is deemed advisable to give half a

fluidram or more of digitalis at once, it is justifiable. It should

be emphasized that the proper dose of digitalis is enough to do the

work. If within a few days there is no marked improvement, the

prognosis is not good. Also, if the digitalis causes cardiac pain

when such was not present, or increases cardiac pains already in

evidence, and causes a tight feeling in the chest, nausea or

vomiting, or a diminished amount of urine, and a tight, bandlike

feeling in the head, digitalis is not acting well, and should be

stopped, or the dose is too large. Also, if there is kidney

insufficiency, or if the digitalis diminishes the output of urine,

it generally should be stopped.



If the blood pressure is high, and perhaps almost always, even in

those who are accustomed to the use of it, tobacco should be

stopped. Tea and coffee should always be withheld from such

patients.



The food and drink should be small in amount, frequently given, and

should be such as especially to meet the needs of the individual,

depending entirely on his general condition and the condition of his

kidneys.





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