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Final clinical long case 13

Created: 21/9/2005
You see a 70-year-old man 4 days after he has undergone abdominal aortic aneurysm repair. His past medical history includes a transient ischaemic attack, non-insulin-dependent diabetes mellitus, hypertension and shortness of breath on exertion. A chest X-ray shows pulmonary oedema, cardiomegaly and right lower lobe collapse with tracheal deviation. An ECG shows new atrial fibrillation (AF) with ischaemia.

1. Discuss AF management in the intensive care unit.
2. What are the possible causes of AF?
3. What other ways do you know to identify AF?
4. What drugs would you administer?

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