A 70-year-old male presents with progressive breathlessness over 6 hours, orthopnoea, and cough productive of pink frothy sputum. He has a known aorti...

Question

A 70-year-old male presents with progressive breathlessness over 6 hours, orthopnoea, and cough productive of pink frothy sputum. He has a known aortic valve replacement performed 5 years ago. He has new-onset atrial fibrillation at 150 bpm. What is the relationship between the new AF and the acute pulmonary oedema?

Accepted Answer

The rapid AF with loss of atrial contraction has precipitated acute decompensation of his valve disease - the loss of atrial kick reduces cardiac output by up to 25%, and the rapid rate reduces diastolic filling time

Answer

The AF was caused by the pulmonary oedema and will resolve spontaneously

Answer

The AF is an incidental finding unrelated to the breathlessness

Answer

AF always indicates mitral valve disease, not aortic

Answer

AF in valve disease patients is always benign

uk-dipimc MCQ (SBA): AF Precipitating Heart Failure