Here's how to tame it. You're caring for Alex Russell, who just had coronary artery bypass graft surgery, when he tells you he feels chest pain and is having trouble catching his breath. Let's start by looking at AF and its causes. Electrical chaos In AF, electrical activity in the atria is disorganized, causing the atria to fibrillate or quiver rather than contract as a unit. The cause of AF may be difficult to pin down.
Elderly patients are at particular risk.
Atrial fibrillation with accompanying exertional dyspnea may be the first sign of thyrotoxicosis. Patients with new-onset AF should have a thyroid profile. With antithyroid management, most can be converted and normal sinus rhythm maintained. With or without myocardial infarction, cardiac ischemia can trigger AF, which may be the first sign of trouble. A patient with newly diagnosed AF should be evaluated for ischemic heart disease.