Auricular Fibrillation Occurrence

This condition of auricular fibrillation occurs occasionally in

valvular disease, and perhaps most frequently in mitral stenosis;

but it can occur without valvular lesions, and with any valvular

lesion. If it occurs in younger patients, valvular disease is apt to

be a cause; if in older patients, sclerosis or myocardial

degeneration is generally present.

It may also follow infections such as diphtheria, or some infection

which has caused a myocarditis. Rarely this fibrillation may be

caused by some of the drugs used to stimulate the heart.

It is astonishing how few symptoms may be present with auricular

fibrillation and an absolutely irregular heart action. The patient

may be able to perform all of his duties, however strenuous, until

coincident, concomitant or causative ventricular weakening and

dilatation of the ventricles or broken compensation occurs, and then

the symptoms are those due to the cardiac failure. Often in the

first stage of this weakening and later fibrillation of the auricles

the patient may recognize the cardiac irregularity and disturbances.

Generally, however, he soon becomes accustomed to the sensations,

and, unless he has cardiac pains or dyspnea, he becomes oblivious to

the irregularity. At other times he may be conscious of irregular,

strong throbs or pulsations of the heart, as such hearts often give

an occasional extra sturdy ventricular contraction. These he notes.

Real attacks of tachycardia may be superimposed on the condition.

Sooner or later, however, if the condition is not stopped, cardiac

weakness and decompensation, with all the usual symptoms, occur. It

seems to be probable that more than half of all cases of heart

failure are due to auricular fibrillation, or at least are

aggravated by it.

As previously stated, ventricular fibrillation is a very serious

condition, and may be a cause of sudden death in angina pectoris,

and is probably then caused by disturbed circulation in one of the

coronary arteries causing an irregular blood supply to one or other

of the ventricles. Absorption of some toxins or poisons which could

act on the blood supply of the ventricles could also be a cause of

this condition. This irregular ventricular contraction sometimes

displaces the apex beat.

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