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Abstract: Palpitation belongs to a type of palpitation. The patient was admitted to the hospital with panic, shortness of breath, heart boredom, and constant breathlessness, which was not relieved by medication, and was diagnosed with persistent atrial fibrillation, which is atrial fibrillation that lasts for more than 7 days and does not terminate on its own, causing a decline in heart function, resulting in heart failure, arrhythmia, and other adverse consequences. After medication and physical therapy, the patient improved and was discharged after 12 days of hospitalization.
Basic information】Female, 63 years old
Disease Type】Stunned (persistent atrial fibrillation)
Hospital】Qilu Hospital of Shandong University
Date of consultation】July 2021
Treatment plan】Oral medications (digoxin tablets, Rosuvastatin calcium tablets, warfarin sodium tablets,) + intravenous infusion (Guahu Piper skin injection, Danshen polyphenolic acid salt for injection) + Chinese herbal soup (Guixin Tang) + physical therapy (medium frequency pulse electricity, extracorporeal counterpulsation therapy)
【Treatment cycle】12 days
【Treatment effect】The patient’s symptoms improved
I. Initial consultation
The patient complained of heart valve replacement and coronary artery bypass grafting for heart valve disease and atrial fibrillation in the past, but he still had atrial fibrillation after the operation, and developed chest tightness and shortness of breath after exertion. The patient was admitted to the hospital with a blood pressure of 97/48 mmHg, no dry or wet rales in both lungs, an irregular heart rhythm, a short pulse, a heart rate of 115 beats/min, and a mechanical sound of the first and second heart sounds on auscultation of the mitral and aortic valves. The patient had no significant abnormalities in the five cardiopulmonary items. The patient had an enlarged left atrium, decreased aortic elasticity, and an electrocardiogram suggesting atrial fibrillation, which was diagnosed as palpitation in Chinese medicine and heart valve disease and persistent atrial fibrillation in Western medicine.
II. Treatment history
The patient’s palpitation, shortness of breath, chest pain and tightness are due to the stagnation of blood vessels caused by the failure of heart yang, which causes palpitation, blood stasis and stagnation of qi, and heart pain if the patient does not pass. The patient was treated with digoxin tablets to control the ventricular rate, lipid-lowering drug resuprastatin calcium tablets, and oral warfarin sodium tablets for anticoagulation due to persistent atrial fibrillation, and traditional Chinese medicine to improve the patient’s spleen, mainly with astragalus, angelica, codonopsis, fried sour date, fried atractylodes, farmer’s root, longan, mucuna pruriens, jujube, and ginger in warm water, supplemented with guahua skin injection The patient’s palpitations and shortness of breath were significantly relieved compared with before, followed by cardiac rehabilitation therapy, exercise therapy for cardiac rehabilitation, improvement of circulation by physiotherapy with medium-frequency pulsed electricity and extracorporeal counterpulsation therapy, and Chinese medicine directed penetrating medicine to relieve local symptoms.
III. Treatment effect
After drug and physical therapy, the patient’s symptoms of panic and shortness of breath were relieved on the 8th day after admission, and only occasionally did he have chest pain. The patient was discharged after 12 days of hospitalization, and his symptoms improved at the time of discharge, and he seemed to be in better spirits than before admission.
IV. Notes
After treatment the patient’s symptoms are relieved, it is very gratifying for the patient, the follow-up patient should eat a light diet, eat less food rich in vitamin K, such as lettuce, egg yolk, pay attention to observe whether there is abnormal bleeding in life or bleeding is not easy to stop, check the international standardized ratio on time, can anticoagulation to prevent thrombosis, and the patient should not stay up late, avoid strain, at the same time should quit smoking, quit drinking, maintain emotional stability, avoid tension The patient should not stay up late, avoid straining, and at the same time should quit smoking and alcohol, keep emotionally stable, avoid tension, anxiety and other restlessness to prevent aggravation.
V. Personal insight
Persistent atrial fibrillation is atrial fibrillation that lasts for more than 7 days and does not terminate on its own, suggesting the need for pharmacological and electrical resuscitation. Persistent atrial fibrillation can cause a decline in heart function, resulting in heart failure, arrhythmia and other adverse consequences. The patient had suffered from heart disease for more than 10 years and had symptoms of panic and shortness of breath due to quarrels with bystanders. Therefore, it is evident that patients with persistent atrial fibrillation should maintain a stable mood and should not be overly excited, but it is good to see that after treatment the patient’s condition has improved and the patient was advised to go home and take rest, avoid tension and excitement and should remain happy.