Heart rate, stroke volume, and cardiac output are dependent on one another, these relationships can provide many clues as to why Jean fainted during her workout session. Which of the following events
could lead to a decrease in cardiac output that could increase Jean's risk of fainting?
Jean did not like the idea of having an echo transducer in her esophagus, but the explanation of what could happen afterward was even more frightening. If Dr. Gardner saw no evidence of blood clots in the echocardiogram, she would then attempt to electrically shock Jean's atria back into a normal sinus rhythm. Direct current cardioversion (DCC) is a procedure that uses electrical current supplied by electrodes applied to the chest and back. Electrical current interrupts the abnormal rhythm, atrial fibrillation in Jean's case, by forcing cardiac muscle cells to contract simultaneously, and hopefully restores normal sinus rhythm. Jean would need to give her consent to proceed with this course of action.
Dr. Gardner discussed alternatives that included using medications to control Jean's heart rate. The main concern for using these medications is that they inherently lower blood pressure. Jean's blood pressure had been in the low normal range, which made this option a concern. Chemical cardioversion, using medication instead of electrical current, was also an option, but Dr. Gardner would still need to know that Jean's heart was free of blood clots. She did not like to use these medications, such as amiodarone, because they had a number of side effects that damaged the thyroid gland and lungs over time. Unfortunately, anticoagulation therapy with blood-thinning medication would be unavoidable if a blood
clot, or thrombus, was detected by echo. Thrombi form in nonfunctional atria, which explains how A Fib and CVA are related. The risk of CVA is greatly increased when normal sinus rhythm is restored, as thrombi can move into the left ventricle and then into the systemic circulation. Thrombi could occlude, or block, small blood vessels that would deprive the brain of blood flow, resulting in a CVA Anticoagulation therapy reduces the risk of blood clot formation and CVA in patients with AFib, Dr. Gardner explained Jean had a relatively low risk for developing CVA based on the medical history she shared with Dr. Gardner. It was possible that she might go home with just instructions to take a baby aspirin once per day for stroke prevention. The doctor did think that Jean should maintain a close relationship with her primary