Atrial fibrillation is a common type of arrhythmia, which is a problem with the rate or rhythm of the heartbeat. This condition often has a very fast and irregular heart rate which can cause poor systemic blood circulation to the body. When atrial fibrillation occurs, the atria’s beat is irregular with chaotic heart rate patterns, and are out of synch with the ventricles of the heart. Atrial fibrillation (AF or A-fib) occurs if rapid and uncoordinated electrical impulse signals cause the atria to “fibrillate”, which mean to contract very rapidly and irregular; when this happens, the blood pools in the atria and isn’t pumped completely into the ventricles, which results in the upper and lower chambers working out of synch. AF may be either occasional, which is called paroxysmal Atrial fibrillation where symptoms come and go at random for a short period lasting for up to a few minutes to a few hours, or chronic, in which symptoms are ongoing and last for years as the heart rhythm is always abnormal.

Before we examine the possible causes for AF we must first understand that in Atrial fibrillation, the atria experience abnormal and chaotic electrical signals which make them “quiver”. The AV node is overloaded with electrical impulses attempting to travel to the ventricles which are also beating very fast, but not as fast as the atria. The resulting effect is, the
heart rhythm is irregular and very rapid. Being that the regular heart rate is 60 to 100 beats per minute, in atrial fibrillation the heart rate may range from 100 to 175 beats per minute.

Damage or abnormalities to the heart’s structure are the most common causes of atrial fibrillation, as well as infarction of the Atrial myocardium, Mitral stenosis and rheumatic heart disease, however other possible causes of AF include: High blood pressure, myocardial infarction, sick sinus syndrome (functioning of the heart’s natural pacemaker), emphysema or other lung diseases, viral infections, congenital heart defects and sleep apnea. Please note that some people who suffer from AF do not have any heart damage or defects, which is a condition called lone atrial fibrillation. The cause of this atria fibrillation is unknown, but serious complications are rare.

Atrial fibrillation (AF) causes the heart to beat inefficiently and usually causes the ventricles to depolarize faster than normal, as a result of this the ventricles cannot fill completely with blood, as such they might not be able to pump enough blood for adequate systemic and pulmonary circulation, this can cause signs and symptoms such as: Palpitations, which are sensations of your heart skipping a beat, a racing or beating too hard or too fast, irregular heartbeat, a fluttering or flopping in your chest. Decreased blood pressure, weakness, confusion,
Chest pain, dizziness or syncope, shortness of breath and fatigue.

The diagnosis of atrial fibrillations is determined by medical and family histories, a physician will perform tests and procedures such as: Electrocardiogram: to measure the electrical impulses given off by the heart. Echocardiogram: in which sound waves are used to produce a video image of the heart. Holter moniter: a portable device that that records all your heat rates as you wear it under your clothes, and records the electrical activity of your heart as you go about your normal day to day routine. Blood tests: This will help your doctor determine a thyroid problem or other agents in the blood that may cause atrial fibrillation. Event recorder: a device. similar to a Holter moniter save for the fact that not all of the heartbeats are recorded. Of the two types of this device, one uses a phone to transmit signals from the recorder while symptoms occur, and the other is worn all the time for a month or longer.

As with all heart diseases, complications may present. Because the atria is not depolarizing completely, blood will begin to pool in the upper chambers and there is a danger that a thrombus or blood clot can form, which in turn can develop and send an embolism, which is a traveling blood clot into the systemic blood circulation, and move on to the brain or lungs which in turn can cause cerebral vascular accident (CVA), renal infraction, pulmonary embolism, and myocardial infarction (MI) or death as there is no way to tell where the embolism will travel to cause severe damage or instant death.

The treatment of atria fibrillation can take many forms and depends on various factors concerning ones health such as the underlying cause of the atrial fibrillation, and if you are able to take certain medications, however the two main goals of treatment are too prevent blood clots and reset the rhythm to control the heart rate which is called cardioconversion. Treatments using cardioconversion attempts to reset the heart rate or rhythm with the use of medications called anti-arrhythmics to restore sinus rhythm with can be administered either orally or intravenously.
Electrical cardioconversion is procedure that is brief utilizing an electrical shock to the heart using patches or “paddles” put on the chest of the patient which stops the electrical impulses of the heart for a moment in hope that when the heart starts to beat again, it will return to a normal sinus rhythm. The patient is sedated as not to feel the electrical shock. Patients after a post electrical cardioconversion procedure are often prescribed anti-arrhythmic medications to prevent the return of atrial fibrillation. The most common medications given are: Amiodarone (Cordarone, Pacerone), Dronedarone (Multaq), Proafenone (Rythmol), Solalol (Betapace), Dofetilde (Tikosyn) and Flecainide (Tambocor). Some side effects of these drugs include fatigue, dizziness and nausea.

Some cases of Atrial fibrillation cannot be converted to a normal sinus rhythm, so the next treatment is to slow the rate back within the range of 60-100 beats per minute, which is called heat rate control. Heart rate control is attempted in two ways, by medications such as digoxin (Lanoxin). This controls the heart rate while at rest, but not so well while being active. Some patients require other medications like beta-blockers or calcium channels blockers, angiotensin-converting enzyme (ACE) inhibitors that are sometimes used to treat hypertension.
If medications are ineffective or if severe side effects occur, Atrioventricular (AV) node ablation may yield results. AV node ablation applies “radiofrequency” energy to the connecting pathway of the upper and lower chambers of the hearts AV node using a long thin catheter to destroy the small area of tissue there to prevent the atria from transmitting electrical impulses to the ventricles, a pacemaker is required to establish a sinus rhythm as well as blood thinning medication to reduce the risk of stroke as the heart is still in atria fibrillation.

Prognosis of atrial fibrillation has a very fair outlook as many patients do very well after treatment which often controls this condition. However atrial fibrillation has a tendency to return and often gets worse despite treatment.

The prevention of atrial fibrillation can be facilitated in many forms. Avoiding binge drinking, eliminate or reduce caffeinated drinks. Also being cautious when taking over the counter medications containing stimulants, like pseudoephedrine which can trigger atrial fibrillation or when taking anti-arrhythmic drugs that can cause adverse interactions.
In conclusion maintaining a healthy lifestyle is the key to preventing any type of health problems. Promoting a healthy heart includes limiting your intake of salt, quit smoking, eat a healthy diet rich in heart healthy foods, lots of exercise, following your doctor’s suggestions and or medication prescriptions on lowing your blood pressure.

Orthopedics is a branch of medicine that deals with the treatment of the disorders or injuries of the bones, joints, and associated muscles. This article will focus on a condition or disease of the knee known as Knee effusion or much more commonly called “Water of the Knee.” The knee joint is made up bone, ligament, cartilage, fluids. Tendons and muscles help the knee joint move. When any one of these structures is damaged or diseased, it can cause pain and difficultly walking. Knee problems and injuries occur in people of all ages, which can interfere with standing and walking.

Some of the main causes of “water on the knee” or rather the cause of the swelling can include, injury to the knee ligaments or a traumatic accident in which after the body’s natural reaction is to flood the knee with a protective fluid, arthritis or an underlying disease or condition like, Cysts, Gout, Infection, Kneecap Bursitis, Over use or Tumors. Now the type of fluid that accumulates around the knee which is the cause of the swelling depends on the condition, disease or traumatic injury that is causing the swelling. In most cases the swelling can be cured easily.

Signs and symptoms of knee effusion (water on the knee) largely depend on the cause of excess fluid built-up in the knee joint. One of the most common symptoms of this condition is knee pain, as in Osteoarthritis usually presents when the knee joints are bearing weight. Pain typically eases with rest however some patients experience severe knee pain while others have no pain at all. In some cases one knee may swell much larger than the other one which may
present with or without pain. Stiffness is a also a common symptom when the knee joints “swells” with excess fluid, the knees may become difficult to bend or straighten in certain areas or the knee as a whole, fluid can also show under the knee when straightened as well. Bearing weight on the knee may be impossible with unbearable pain being present.

The diagnosis of knee effusion can be carried out in a few different ways, such as blood tests to determine if the inflammation is due to rheumatoid arthritis or a crystalline arthritis like joint infection, gout or pseudo-gout. In addition to lab analysis of the joint fluid, blood tests such as a C-reactive protein or uric acid, erythrocyte sedimentation rate (ESR) and a white cell blood count. If Lyme’s disease antibodies are detected forming in the blood that may also be a possible cause of this condition.

Joint aspiration which is a procedure known as arthrocentesis, in which fluid within the knee is withdrawn using a needle syringe and sent to a lab for analysis such as cell count, culture for bacteria and the presence of crystals like calcium pyrophosphate dehydrate crystals which is found in cases of gout.

Complications of this condition can hamper one’s ability to play sports such as basketball, tennis or football, to just walking short distances and also from participation in any activities that require knee mobility.
While treatment of knee effusion depends on the underlying cause of the swelling, there are general measures that usually provide relief, like analgesics, rest, ice and cold compressions and NSAIDS, which can reduce swelling and treat pain.

As stated previously, in most cases of knee effusion the swelling and pain aspect can be resolved with ease depending on the underlying cause. In case of the cause being Gout or Lyme’s disease, treatment for those disorders should clear up the problem in time.

Prevention of knee effusion as stated prior, depends on the conditions of the underlying cause, however certain general safeguards can be applied, such as not putting too much pressure or weight on the knee’s and not overdoing certain exercises such as prolonged running or jumping ,which can cause trauma to the knees causing effusion of excess synovial fluid. Also wearing shoes with sole cushions to absorb the shock of running and long distance walking can also be helpful.

In conclusion, knee effusion though very common can be a very painful and immobilizing experience, with symptoms that are not difficult to treat depending on the various conditions of the cause.