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Multifocal Atrial Tachycardia
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Posted by dkwinter
Etiology
exacerbation of pulmonary disease (e.g. COPD)
electrolyte disturbance
catecholamine surge (e.g. sepsis)
Common history
elderly patients with an acute exacerbation of underlying pulmonary disease (e.g. COPD)
symptoms related to etiology (e.g. cough, wheeze and shortness of breath)
Clinical findings
typically asymptomatic
rapid, irregular pulse
at least 3 distinct P wave morphologies
atrial rate >100/min
Management
treat the underlying etiology, commonly:
COPD exacerbation
supplemental oxygen (=/- ventilation)
steroids
antibiotics
only if absolutely necessary, venticular rate can be controlled with
nondihydropyridine calcium channel blockers (e.g. verapamil, diltiazem)
beta-blockers