中英双语解读心房颤动房颤Atrial fibrillationWord文档下载推荐.docx

中英双语解读心房颤动房颤Atrial fibrillationWord文档下载推荐.docx

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男性患者栓塞发病率在各年龄段均高于女性。

房颤的总患病率、年龄分组、性别分组、病因分组后的患病率均和国外相关资料的趋势接近。

中国因房颤而住院的患者也有增加的趋势。

随着我国人口的老龄化，房颤的负担无疑会越来越重。

我国房颤患者并发脑卒中的发生情况也与国外类似。

在平均70岁的非瓣膜病房颤患者中，缺血性脑卒中的发生率为5.3%，与欧美国家相似（4%~6%）。

住院患者房颤的脑卒中患病率达24.8%，且有明显随年龄增加趋势，80岁以上脑卒中患病率高达32.9%。

Overview

Atrialisafibrillationnirregularandoftenrapidheartratethatcanincreaseyourriskofstrokes,heartfailureandotherheart-relatedcomplications.

Duringatrialfibrillation,theheart'

stwoupperchambers（theatria）beatchaoticallyandirregularly—outofcoordinationwiththetwolowerchambers（theventricles）oftheheart.Atrialfibrillationsymptomsoftenincludeheartpalpitations,shortnessofbreathandweakness.

Episodesofatrialfibrillationmaycomeandgo,oryoumaydevelopatrialfibrillationthatdoesn'

tgoawayandmayrequiretreatment.Althoughatrialfibrillationitselfusuallyisn'

tlife-threatening,itisaseriousmedicalconditionthatsometimesrequiresemergencytreatment.

Amajorconcernwithatrialfibrillationisthepotentialtodevelopbloodclotswithintheupperchambersoftheheart.Thesebloodclotsformingintheheartmaycirculatetootherorgansandleadtoblockedbloodflow（ischemia）.

Treatmentsforatrialfibrillationmayincludemedicationsandotherinterventionstotrytoaltertheheart'

selectricalsystem.

Symptoms

Somepeoplewithatrialfibrillationhavenosymptomsandareunawareoftheirconditionuntilit'

sdiscoveredduringaphysicalexamination.Thosewhodohaveatrialfibrillationsymptomsmayexperiencesignsandsymptomssuchas:

Palpitations,whicharesensationsofaracing,uncomfortable,irregularheartbeatoraflip-floppinginyourchest

Weakness

Reducedabilitytoexercise

Fatigue

Lightheadedness

Dizziness

Shortnessofbreath

Chestpain

Atrialfibrillationmaybe:

Occasional. 

Inthiscaseit'

scalledparoxysmal（par-ok-SIZ-mul）atrialfibrillation.Youmayhavesymptomsthatcomeandgo,usuallylastingforafewminutestohours.Sometimessymptomsoccurforaslongasaweekandepisodescanhappenrepeatedly.Yoursymptomsmightgoawayontheirownoryoumayneedtreatment.

Persistent. 

Withthistypeofatrialfibrillation,yourheartrhythmdoesn'

tgobacktonormalonitsown.Ifyouhavepersistentatrialfibrillation,you'

llneedtreatmentsuchasanelectricalshockormedicationsinordertorestoreyourheartrhythm.

Long-standingpersistent. 

Thistypeofatrialfibrillationiscontinuousandlastslongerthan12months.

Permanent. 

Inthistypeofatrialfibrillation,theabnormalheartrhythmcan'

tberestored.You'

llhaveatrialfibrillationpermanently,andyou'

lloftenrequiremedicationstocontrolyourheartrateandtopreventbloodclots.

Whentoseeadoctor

Ifyouhaveanysymptomsofatrialfibrillation,makeanappointmentwithyourdoctor.Yourdoctormayorderanelectrocardiogramtodetermineifyoursymptomsarerelatedtoatrialfibrillationoranotherheartrhythmdisorder（arrhythmia）.

Ifyouhavechestpain,seekemergencymedicalassistanceimmediately.Chestpaincouldsignalthatyou'

rehavingaheartattack.

病因

1.房颤的急性原因

房颤与某些急性、暂时性原因有关，包括饮酒、外科手术、电击、心肌炎、肺栓塞、其它肺脏病以及甲状腺机能亢进，治疗基础疾病可以消除房颤。

房颤是心肌梗塞和心胸外科手术后较常见的早期并发症。

2.不伴有相关心血管疾病的房颤

年轻患者中，大约30%（45%的阵发性房颤和20%（25%的持续性房颤属于孤立性房颤。

3.伴有相关心血管病的房颤

与房颤有关的心血管病包括瓣膜性心脏病（大多为二尖瓣性）、冠心病（CAD）以及高血压，尤其是存在左室肥厚（LVH）时。

4.神经性房颤

自主神经系统通过提高迷走神经或交感神经张力可以触发易感病人发生房颤。

许多患者房颤发作都是出现在迷走神经和交感神经张力增强的时候。

Coumel描述了一组病人，并将其分为迷走型房颤和交感型房颤。

纯粹迷走型房颤或交感型房颤患者比较少见，但是如果患者有某型房颤发作史以及相关特征性症状之一，那么临床医师选用相应药物才能更有效地防止反复发作。

Causes

Atrialfibrillationisanirregularandoftenrapidheartratethatoccurswhenthetwoupperchambersofyourheartexperiencechaoticelectricalsignals.Theresultisafastandirregularheartrhythm.Theheartrateinatrialfibrillationmayrangefrom100to175beatsaminute.Thenormalrangeforaheartrateis60to100beatsaminute.

Yourheartismadeupoffourchambers—twoupperchambers（atria）andtwolowerchambers（ventricles）.Withintheupperrightchamberofyourheart（rightatrium）isagroupofcellscalledthesinusnode.Thisisyourheart'

snaturalpacemaker.Thesinusnodeproducesthesignalthatnormallystartseachheartbeat.

Normally,thesignaltravelsthroughthetwoupperheartchambers,andthenthroughaconnectingpathwaybetweentheupperandlowerchamberscalledtheatrioventricular（AV）node.Themovementofthesignalcausesyourhearttosqueeze（contract）,sendingbloodtoyourheartandbody.

Inatrialfibrillation,thesignalsintheupperchambersofyourheartarechaotic.Asaresult,theyquiver.TheAVnode—theelectricalconnectionbetweentheatriaandtheventricles—isbombardedwithimpulsestryingtogetthroughtotheventricles.

Theventriclesalsobeatrapidly,butnotasrapidlyastheatria,asnotalltheimpulsesgetthrough.

Possiblecausesofatrialfibrillation

Abnormalitiesordamagetotheheart'

sstructurearethemostcommoncauseofatrialfibrillation.Possiblecausesofatrialfibrillationinclude:

Highbloodpressure

Heartattack

Coronaryarterydisease

Abnormalheartvalves

Heartdefectsyou'

rebornwith（congenital）

Anoveractivethyroidglandorothermetabolicimbalance

Exposuretostimulants,suchasmedications,caffeine,tobaccooralcohol

Sicksinussyndrome—improperfunctioningoftheheart'

snaturalpacemaker

Lungdiseases

Previousheartsurgery

Viralinfections

Stressduetosurgery,pneumoniaorotherillnesses

Sleepapnea

However,somepeoplewhohaveatrialfibrillationdon'

thaveanyheartdefectsordamage,aconditioncalledloneatrialfibrillation.Inloneatrialfibrillation,thecauseisoftenunclear,andseriouscomplicationsarerare.

Atrialflutter

Atrialflutterissimilartoatrialfibrillation,buttherhythminyouratriaismoreorganizedandlesschaoticthantheabnormalpatternscommonwithatrialfibrillation.Sometimesyoumayhaveatrialflutterthatdevelopsintoatrialfibrillationandviceversa.

Theriskfactorsforandthesymptomsandcausesofatrialflutteraresimilartothoseofatrialfibrillation.Forexample,strokesarealsoaconcerninsomeonewithatrialflutter.Aswithatrialfibrillation,atrialflutterisusuallynotlife-threateningwhenit'

sproperlytreated.

Riskfactors

Certainfactorsmayincreaseyourriskofdevelopingatrialfibrillation.

Theseinclude:

Age. 

Theolderyouare,thegreateryourriskofdevelopingatrialfibrillation.

Heartdisease. 

Anyonewithheartdisease—suchasheartvalveproblems,congenitalheartdisease,congestiveheartfailure,coronaryarterydisease,orahistoryofheartattackorheartsurgery—hasanincreasedriskofatrialfibrillation.

Highbloodpressure. 

Havinghighbloodpressure,especiallyifit'

snotwell-controlledwithlifestylechangesormedications,canincreaseyourriskofatrialfibrillation.

Otherchronicconditions. 

Peoplewithcertainchronicconditionssuchasthyroidproblems,sleepapnea,metabolicsyndrome,diabetes,chronickidneydiseaseorlungdiseasehaveanincreasedriskofatrialfibrillation.

Drinkingalcohol. 

Forsomepeople,drinkingalcoholcantriggeranepisodeofatrialfibrillation.Bingedrinkingmayputyouatanevenhigherrisk.

Obesity. 

Peoplewhoareobeseareathigherriskofdevelopingatrialfibrillation.

Familyhistory. 

Anincreasedriskofatrialfibrillationispresentinsomefamilies.

Complications

Sometimesatrialfibrillationcanleadtothefollowingcomplications:

Stroke. 

Inatrialfibrillation,thechaoticrhythmmaycausebloodtopoolinyourheart'

supperchambers（atria）andformclots.Ifabloodclotforms,itcoulddislodgefromyourheartandtraveltoyourbrain.Thereitmightblockbloodflow,causingastroke.

Theriskofastrokeinatrialfibrillationdependsonyourage（youhaveahigherriskasyouage）andonwhetheryouhavehighbloodpressure,diabetes,ahistoryofheartfailureorapreviousstroke,andotherfactors.Certainmedications,suchasbloodthinners,cangreatlyloweryourriskofastrokeorthedamagetootherorganscausedbybloodclots.

Heartfailure. 

Atrialfibrillation,especiallyifnotcontrolled,mayweakentheheartandleadtoheartfailure—aconditioninwhichyourheartcan'

tcirculateenoughbloodtomeetyourbody'

sneeds.

Prevention

Topreventatrialfibrillation,it'

simportanttoliveaheart-healthylifestyletoreduceyourriskofheartdisease.Ahealthylifestylemayinclude:

Eatingaheart-healthydiet

Increasingyourphysicalactivity

Avoidingsmoking

Maintainingahealthyweight

Limitingoravoidingcaffeineandalcohol

Reducingstress,asintensestressandangercancauseheartrhythmproblems

Usingover-the-countermedicationswithcaution,assomecoldandcoughmedicationscontainstimulantsthatmaytriggerarapidheartbeat