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Auricular Fibrillation TreatmentCategory: Uncategorized Source: 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. Next: Pulsus Alternans Previous: Auricular Fibrillation Prognosis
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