Dr. Huynh Thanh Kieu, Head of Cardiology Department 1 at the Heart Center, Tam Anh General Hospital TP HCM, reported that Mr. Dien's heart rate reached 180-190 beats per minute due to atrial fibrillation with rapid ventricular response. He was disoriented, confused, and delirious. A magnetic resonance imaging (MRI) scan revealed a right hemispheric cerebral infarction, a dangerous complication of atrial fibrillation.

Dr. Pham Phong Luan, from Cardiology Department 1 at the Heart Center, Tam Anh General Hospital TP HCM, explained that during atrial fibrillation, the heart's two upper chambers (atria) contract rapidly, chaotically, and irregularly. This causes blood to pool in the atria, creating conditions for blood clots to form in the heart. These blood clots are then pumped out by the heart, traveling through the bloodstream to the brain or other organs, leading to stroke or acute vascular occlusion. "Patients with atrial fibrillation have a 5-7 times higher risk of stroke compared to those without the condition," Dr. Luan stated. Untreated atrial fibrillation also increases the risk of heart failure, acute myocardial infarction, and prolonged hospitalization.

Mr. Dien had undergone mitral and aortic valve replacement several years prior. According to Dr. Kieu, atrial fibrillation in patients with underlying valvular heart disease is common because the condition alters the heart's structure and function. Although the patient used anticoagulants as prescribed, the medication only reduces stroke risk by 60-70% and does not eliminate the risk entirely. Mr. Dien was fortunate to be brought to the hospital early, so the sequelae were not severe.

Doctors treated him with anticoagulants, adjusting the dosage according to a suitable regimen to prevent recurrent thrombosis, along with heart rate control medication and support for heart function. He regained consciousness, stopped being delirious, no longer had seizures, and his drooping eyelid gradually improved. He underwent post-stroke physical therapy and was discharged after 9 days.

Doctor Luan examines the patient before discharge. *Photo: Ha Vu*

Patients with atrial fibrillation often do not experience clear symptoms, only discovering the condition during routine health check-ups or when stroke complications occur, as in Mr. Dien's case. Some individuals may experience palpitations, a pounding heart, shortness of breath, fatigue, reduced exercise tolerance, breathlessness, dizziness, presyncope, or chest tightness. Atrial fibrillation typically results from a combination of factors, including: post-heart surgery, congenital heart disease, cardiomyopathy, valvular heart disease, coronary artery disease, hypertension, heart failure, chronic lung disease, hyperthyroidism, viral infections, sleep apnea, pericarditis, and advanced age (over 60 years old).

To prevent atrial fibrillation from causing stroke, in addition to taking anticoagulants, patients need to maintain a healthy lifestyle. This includes: regular exercise, not smoking, limiting alcohol and caffeine intake, avoiding stress, and managing underlying conditions such as hypertension, diabetes, and dyslipidemia. They should eat plenty of fiber, poultry, fish, and olive oil, while avoiding fast food, processed foods, high-salt foods, and sweets. Patients must adhere to regular follow-up appointments and seek immediate medical attention if stroke symptoms appear, including: facial paralysis, slurred speech, weakness or numbness on one side of the body, or bleeding symptoms such as blood in urine, bleeding gums, or black stools.

Thu Ha

*Patient's name has been changed