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Fibrilação auricular

O que é? Qual é o tratamento?

A fibrilação auricular ou FA é o tipo mais frequente de arritmia: é um problema de frequência ou de pulsação cardíaca, no qual o coração pulsa muito rápido ou tem um ritmo irregular. A FA é produzida quando há sinais elétricos desorganizados que provocam uma contração ou um tremor incontrolável de fibras musculares (fibrilas) das aurículas, que são as duas cavidades superiores do coração. Na fibrilação auricular, a força de contração do coração é menor que a devida e isso faz com que o sangue se acumule, podendo formar coágulos. Se alguns coágulos se desprenderem, podem deslocar-se ao cérebro, onde podem fixar-se nas artérias cerebrais, bloquear o fluxo sanguíneo e provocar um ictus: um episódio cerebrovascular que causa anomalias na função neurológica e dura mais de 24 horas. A fibrilação auricular pode ser breve, com sintomas que aparecem e desaparecem, e tem episódios que se resolvem por si mesmos. Porém, às vezes é permanente, e nem remédios ou outros tratamentos podem restaurar um ritmo cardíaco normal.

Quais são as causas?

À medida que envelhecemos, especialmente depois dos 60 anos, o risco de sofrer fibrilação auricular  aumenta. A hipertensão arterial e a doença coronária estão ligadas à fibrilação auricular, tal como outras doenças cardíacas e pulmonares. Outros fatores de risco podem incluir estresse, consumo de álcool e café, pílulas para emagrecer, tabagismo e fatores congênitos.

Quais são os sintomas?

Às vezes, as arritmias podem passar despercebidas, mas outras podem causar desmaios, tonturas, atordoamento, palpitações, pulsações cardíacas adicionais ou faltantes, fragilidade, dificuldade para respirar e dor no peito.

Ao identificar esses sintomas, consulte seu médico.

Como é diagnosticada? Qual é o tratamento?

Em geral, o médico realizará um eletrocardiograma (ECG), um exame que mostra como os sinais elétricos se deslocam pelo coração, para diagnosticar as arritmias supraventriculares. Depois, o tratamento dependerá de cada paciente e de seus sintomas. São considerados fatores como a idade, o estado geral de saúde, os antecedentes pessoais e familiares, se toma remédios por causa de outras doenças, causas subjacentes que possam contribuir à arritmia, a natureza e a gravidade da arritmia e seus sintomas. O tratamento dos pacientes com FA tem como objetivo reduzir os sintomas e o risco de complicações graves ligadas a esta doença, tais como o AVC. A pedra angular para reduzir o risco de acidente cerebrovascular em pacientes com FA é a terapia oral anticoagulante. Além do mais, existem estratégias não farmacológicas, como o fechamento do apêndice atrial esquerdo, que oferecem alternativas terapêuticas, tais como para os pacientes com FA não valvular que precisam de um tratamento para a formação potencial de um trombo no apêndice esquerdo e têm uma contra-indicação para o tratamento anticoagulante. Essas intervenções específicas oferecem uma solução permanente para os pacientes com FA e eliminam a necessidade de um tratamento com anticoagulantes orais por toda a vida. Também, sugerem-se mudanças no estilo de vida, como uma dieta mais saudável, restringir ou eliminar o consumo de café, realizar exercício com frequência e deixar de fumar.

Antes de iniciar o tratamento, consultar sempre um médico.

O Ictus ou ACV

Segundo a OMS, o Ictus ou Acidente Vascular Cerebral (AVC) é a segunda principal causa de morte no mundo; das quinze milhões de pessoas por ano que o sofrem, cinco milhões morrem e outros cinco milhões de pessoas ficam com alguma deficiência para sempre. Calcula-se que a FA causa 15% de todos os AVC. A prevalência do AVC nos pacientes com FA maiores de 70 anos duplica-se a cada década, e quem sofre de FA tem cinco vezes mais chances de sofrer um AVC que o resto da população em geral.

Quais são os sintomas do AVC?

Os indicadores mais frequentes são: fraqueza ou dormência repentina do rosto, braço ou perna, na maioria das vezes de um lado do corpo. Outros sintomas são confusão, dificuldade para falar ou compreender a linguagem falada, dificuldade para ver com um ou dois olhos, dificuldade para caminhar, perda de equilíbrio ou coordenação, dor de cabeça intensa sem causa conhecida e desmaios ou perda do conhecimento.