Atrial fibrillation : The ventricular rate in atrial fibrillation can be controlled with a beta-blocker or diltiazem.or verapamil. Digoxin is usually effective for controlling the rate at rest; it is also appropriate if atrial fibrillation is accompanied by congestive heart failure. If the rate at rest or during exercise cannot be controlled, diltiazem or verapamil may be combined with digoxin, but care is required if the ventricular function is diminished. In some cases, e.g. acute atrial fibrillation or paroxysmal atrial fibrillation, diltiazem or verapamil or a beta-blocker may be more appropriate than digoxin (see also Paroxysmal Supraventricular Tachycardia and Supraventricular Arrhythmias below). Anticoagulants are indicated especially in valvular or myocardial disease, and in the elderly; in the very elderly the overall benefit and risk needs careful assessment. Younger patients with lone atrial fibrillation in the absence of heart disease probably do not need anticoagulation. Aspirin is less effect than warfarin at preventing emboli but may be appropriate if there are no other risk factors for stroke; aspirin 75 mg may be used.
Atrial flutter : The ventricular rate at rest can sometimes be controlled with digoxin. Reversion to sinus rhythm (if indicated) may be achieved by appropriately synchronised d.c. shock. Alternatively, amiodarone may be used to restore sinus rhythm, and amiodarone or sotalol to maintain it. If the arrhythmia is long-standing a period of treatment with anticoagulants should be considered before cardioversion to avoid the complication of emboli.
Drugs used - Digoxin, Amiodarone and Sotalol
Hypertension : Hypertension, also referred to as high blood pressure, is a condition in which the arteries have persistently elevated blood pressure. Every time the human heart beats, it pumps blood to the whole body through the arteries.
Blood pressure is the force of blood pushing up against the blood vessel walls. The higher the pressure the harder the heart has to pump. Hypertension can lead to damaged organs, as well as several illnesses, such as renal failure (kidney failure), aneurysm, heart failure, stroke, or heart attack.
The normal level for blood pressure is below 120/80, where 120 represents the systolic measurement (peak pressure in the arteries) and 80 represents the diastolic measurement (minimum pressure in the arteries). Blood pressure between 120/80 and 139/89 is called pre hypertension (to denote increased risk of hypertension), and a blood pressure of 140/90 or above is considered hypertension.
Hypertension may be classified as essential or secondary. Essential hypertension is the term for high blood pressure with unknown cause. It accounts for about 95% of cases. Secondary hypertension is the term for high blood pressure with a known direct cause, such as kidney disease, tumors, or birth control pills.