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The Relationships among Uncertainty, Appraisal of Uncertainty, Depression, Anxiety and Perceived Health Status in Patients with Atrial Fibrillation (심방세동 환자의 불확실감, 불확실감의 평가, 우울, 불안, 주관적 건강지각 간의 관계)

  • Kang, Younhee
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.230-238
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    • 2005
  • Purpose: The purposes of this study were to explore the concept of uncertainty and to examine the relationships among uncertainty, appraisal of uncertainty, depression, anxiety, and perceived health status in patients with atrial fibrillation. Method: The study utilized a descriptive correlational survey design using a face to face interview method. A convenience sample of 49 subjects were recruited from K university hospital over 8 months. The data were analyzed by t-test, ANOVA, Pearson correlation and partial correlation analysis. Results: 1) Subjects perceived with moderately high uncertainty(M=65.98); moderate physical health(M=39.80), mental health(M=47.38), and general health(M=2.94); moderate anxiety(M= 44.78); and slightly low depression(M=15.33). 2) There were significant differences in uncertainty by gender and education. 3) Uncertainty and danger appraisal were significantly correlated(r=.32, p=.03) while the uncertainty was not associated with opportunity appraisal. 4) Uncertainty was significantly correlated with mental health(r=-.31, p=.04), anxiety(r=.38, p=.01), and depression(r=.37, p=.01). Conclusion: This study was the first trial to explore uncertainty and to examine the relationships among its associated factors in Korean patients with atrial fibrillation. Thus, based on the findings of this study, directions for nursing practice and further nursing research for patients with atrial fibrillation were suggested.

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Factors Influencing Health-related Quality of Life in Patients with Atrial Fibrillation (심방세동 환자의 건강 관련 삶의 질 영향요인)

  • Lee, Seon Jeong;Seo, Ji Min
    • Korean Journal of Adult Nursing
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    • v.25 no.1
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    • pp.13-23
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    • 2013
  • Purpose: The purpose of this study was to investigate the factors that influence health-related quality of life in patients with atrial fibrillation. Methods: The subjects were 150 outpatients with atrial fibrillation who visited the cardiology clinic of a university hospital in U city. The instruments used for this study were Mhel Uncertainty in Illness Scale (MUIS), Center for Epidemiologic Studies-Depression Scale (CES-D), State Trait Anxiety Inventory (STAI), and the Short-Form-36 Health Survey (SF-36) Korean version II. The date were analyzed by ANOVA, Pearson-correlation coefficient, and hierachial multiple regression using SPSS/WIN 18.0. Results: The mean score of physical health-related quality of life (PCS) was $38.92{\pm}6.22$ and mental health-related quality of life (MCS) was $41.49{\pm}5.71$. Physical and Mental health-related quality of life had the significant correlations with uncertainty, anxiety and depression. In multiple regression analysis, physical health-related quality of life was significantly influenced by duration of disease, NYHA class, uncertainty. Mental health-related quality of life was significantly influenced by family income, NYHA class, anxiety and depression. Conclusion: These results suggest that these influencing factors should be consider in developing the nursing interventions to improve the healthrelated quality of life in patients with atrial fibrillation.

Relation of Left Atrial Wall Pathology to Atrial Fibrillation and Left Atrial Dimension in Mitral Valvular Diseases. (승모판질환에서 좌심방벽 생검소견과 심방세동 및 좌심방 크기의 관계)

  • 김광호
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.1-9
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    • 1988
  • The left atrial [LA] dimension and atrial fibrillation [AF] in patients with mitral valvular heart diseases have been thought to be related to hemodynamic burden to the LA depending on severity of stenosis or regurgitation of mitral valve, left ventricular contractility and the heart conditions. If hemodynamic burden persists long, it can affect the LA wall and structural change of the LA wall itself can developed. So the structural change of the LA wall could be thought to be related to the LA dimension and AF. To verify this relation, the LA wall biopsy was performed in 26 patients with rheumatic mitral valvular heart disease at the left atriotomy incision margin which was posterior to the interatrial groove after completion of surgery to the mitral valve such as valve replacement or commissurotomy. Relation of the pathological state of the LA wall to AF and the LA dimension measured by M-mode echocardiography was studied. The conclusions were as follow. 1. There was tendency that degree of fibrosis of myocardium of the LA wall was related to the LA dimension. 2. There was more chance that patients who had severe fibrosis of myocardium of the LA wall had pre and postoperative AF. 3. There was no relation between reduction rate of the LA dimension before and after surgery and degree of fibrosis of myocardium of the LA wall.

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Congenital Left Atrial Appendage Aneurysm - A case report- (선천성 좌심방이류 - 1례 보고 -)

  • 김근직;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.827-830
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    • 1999
  • Congenital left atrial appendage aneurysm is a very rare congenital cardiac abnormality. That is postulated to arise from a developmental weakness in the atrial wall in utero. Clinically, patients are often asymptomatic and are diagnosed incidentally, but supraventricular arrhythmias and systemic thromboembolism have also been reported in some cases. Surgical resection at the time of diagnosis is recommended because of the propensity for thromboembolic complications. A 13-month-old female, who was suspected preoperatively as having partial absence of pericardium with left atrial herniation through the defect, underwent surgical resection of the left atrial appendage aneurysm. Exposure through a median sternotomy showed an intact pericardium. The postoperative course was uneventful.

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Coronary Artery fistula Associated with Atrial Septal Defect -Report of one case- (심방중격결손증을 동반한 관상동맥루 - 1례 보고 -)

  • 서연호;신동진;김공수
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.463-466
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    • 2002
  • We present a case of coronary artery fistula originating from the proximal left anterior descending artery draining into the main pulmonary artery, which was associated with atrial septal defect. The patient was a 56 year old male who was admitted for exertional dyspnea and abdominal distension. Echocardiogram and selective coronary arteriogram revealed a atrial septal defect and fistulous connection. The patient underwent surgery under the cardiopulmonary bypass with fibrillating heart. The pericardial patch closure of atrial septal defect and internal obliteration of the fistula termination site in the main pulmonary artery were performed. Postoperative hospital courses were uneventful without any specific complication and the patient was discharged without problem.

Surgical Removal of Large Thrombus at the Suture Site of the Right Atriotomy after Atrial Septal Defect Closure Associated with Pulmonary Embolism -1case- (심방중격결손 수술 후 폐색전증을 동반한 우심방 절개 봉합 부위에서의 우심방 혈전의 수술적 치료 -1예보고-)

  • 황여주;안영찬;전양빈;이재웅;박철현;박국양;이창하
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.448-451
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    • 2004
  • Report of right atrial thrombus complicating pulmonary embolism after cardiac surgery is rare. A 54-year-old woman operated on the atrial septal defect 10 months ago was admitted for left pleuritic pain and dyspnea. Multiple segmental perfusion defects were detected in lung perfusion scan. Transesophageal echocardiography showed a large mobile right atrial mass attached to the free wall of the right atrium with a stalk. Despite the intravenous heparinization for 13 days, follow-up echocardiography revealed the right atrial mass had not diminished in size. The mass which was confirmed as an organizing thrombus was excised under cardiopulmonary bypass. The patient recovered uneventfully and was discharged on warfarin therapy.

Right Atrial Thrombus Mimicking Right Atrial Myxoma (우심방 점액종으로 오인된 우심방 혈전)

  • Han, Jong-Hee;Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Na, Myung-Hoon
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.132-135
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    • 2007
  • A right atrial thrombus in structurally normal heart is very rare. A 66-year-old woman was admitted with chest discomfort and dyspnea. She was diagnosed of right atrial myxoma on echocardiography and chest computed tomography, We peformed an excision of the mass attached to atrial septum, which was found to be an organized mural thrombus by pathologic examination. We report this rare case with a review of literature.

Idiopathic Atrial Standstill in an Old English Sheepdog Cross Dog (Old English Sheepdog Cross Dog에서의 특발성 심방정지)

  • Suh, Sang-il;Choi, Ran;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.330-333
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    • 2015
  • An 1 year old intact male mixed dog (weighing 20 kg) was presented with primary complaints of abdominal distension and severe exercise intolerance. Electrocardiogram found profound bradycardia (46-79 beats/min) with atrial standstill. Laboratory studies found no particular abnormalities. Serum cortisol and T4 concentration were within normal range. Diagnostic imaging studies revealed generalized cardiomegaly, ascites, dilation in all cardiac chambers, absence of atrial contraction, absence of transmitral A-peak, mitral and tricuspid valve insufficiency and normal left ventricular systolic dimension. Based on diagnostic findings, the case was diagnosed as idiopathic atrial standstill. The dog was treated with conventional therapy for heart failure.

Decision-Making in Transcatheter Edge-to-Edge Repair: Insights into Atrial Functional Mitral Regurgitation

  • Kim, Joon Bum
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.449-453
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    • 2021
  • The 2020 American College of Cardiology focused update on the mitral regurgitation (MR) pathway provides an excellent summary of the decision-making trees in the treatment of severe MR, in which 2 main branches of the flowchart are suggested depending on whether MR is primary or secondary. Surgery is suggested as preferable over transcatheter edge-to-edge repair (TEER) in primary MR that needs intervention. The decision-making for secondary MR generally prioritizes TEER over surgery according to the guidelines, but further stratification is necessary based on the pathophysiologic mechanisms of MR. TEER is probably the more suitable option in secondary MR caused by left ventricular dysfunction or dilatation, given the high perceived surgical risks, despite the lack of sufficient evidence in support of overt clinical benefits from surgical therapy in these patients. In atrial functional MR associated with atrial fibrillation (AF), however, concomitant ablation of AF seems to be a desirable option, as it has been demonstrated to be a key factor leading to improved survival, reduced stroke risk, and more durable mitral and tricuspid function in patients undergoing mitral surgery. Therefore, atrial functional MR requiring intervention may be best treated by surgical therapy that combines mitral repair and AF ablation in the majority of patients. This particular issue, however, needs further research to obtain scientific evidence to guide optimal management strategies.

A Review of Cardioembolic Stroke Patients Hospitalized in Hospital of Korean Medicine (한방병원에 입원한 심인성 뇌색전증 환자에 대한 고찰)

  • Park, Young-Hwa;Lim, Bo-Ra;Jeon, Gyeong-Ryung;Kwon, Do-Ick
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.18 no.1
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    • pp.55-65
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    • 2017
  • ■ Objectives Atrial fibrillation is the most common cause of cardioembolic stroke. Of the 44 ischemic stroke patients with atrial fibrillation who were hospitalized in hospital of Korean Medicine from July 1, 2014 to June 30, 2017, we selected 39 patients who have had Magnetic Resonance Angiography. We divided them into Atrial Fibrillation group with no stenosis or less than 50% stenosis in the ipsilateral artery of the lesion and Artery to Artery Embolism group with more than 50% stenosis or occlusion in the ipsilateral artery of the lesion. ■ Methods Clinical characteristics, examination and evaluation tools were collected from the patient's electronic medical records. CHADS2, Initial National Institutes of Health Stroke Scale, 8-item Stroke Scale and Improved 8-item Stroke Scale Number were checked. ■ Results & Atrial Fibrillation group showed differences in age, brain lesion location, vascular lesion, Conclusion initial National Institutes of Health Stroke Scale, initial 8-item Stroke Scale and progress compared to Artery to Artery Embolism group.

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