Changes

== Diagnosis ==

== Diagnosis ==

A full '''history and clinical examination''' may provide a presumptive diagnosis for this condition. Findings on clinical examination will include an '''irregularly irregular heart rhythm''' on auscultation with no fourth heart sound. The heart will sound 'chaotic'. There may also be a '''variable pulse quality''' and a variable intensity of heart sounds.

History and physical examination may provide a presumptive diagnosis for this condition. Findings on clinical examination will include an '''irregularly irregular heart rhythm''' on auscultation with no fourth heart sound. The heart will sound 'chaotic'. There may also be a '''variable pulse quality''' and a variable intensity of heart sounds.

An '''electrocargiogram''' (ECG) can be performed for a definitive diagnosis of atrial fibrillation. It will show a '''lack of P waves''' and instead 'F waves'. The ventricular rate is high, the interval between QRS complexes is irregular but the QRS complexes themselves appear normal.

===Electrocardiogram (ECG)===

 

'''Atrial flutter on ECG''' has the following features: the atrial rhythm is regular, at approximately 300-400 beats per minute. P waves are usually discrete P waves or a saw-toothed baseline. Ventricular rhythm and rate generally depend on the atrial rate and AV nodal conduction, but are generally regularly irregular and rapid. It can sometimes mimic atrial fibrillation.

* No P waves

 

'''Echocardiography and radiography''' may help characterise the type and severity of the heart disease, if present. Mild left atrial enlargement may accompany the haemodynamic alterations imposed by the arrythmia.

* Ventricular rate variable

====Atrial Fibrillation===

* Coarse oscillation of the baseline (F-waves)

* R-R interval irregular and chaotic

Echocardiography is recommended to determine the type and severity of any underlying structural heart disease. Mild left atrial enlargement may accompany the haemodynamic alterations imposed by the arrythmia.

==Treatment==

==Treatment==