Nama : Aura Discyacitta Firstisha Putri

NRP : 1710211036
Kelas Tutorial : C2
Tugas Case 2 : Kenapa atrial fibrillation dapat menyebabkan ischemic stroke?
Dan jelaskan Skoring CHA2DS2-VASc!
Atrial fibrillation (AF or AFib) is the most common irregular heart rhythm
that starts in the atria. Instead of the SA node (sinus node) directing the electrical
rhythm, many different impulses rapidly fire at once, causing a very fast, chaotic
rhythm in the atria. Because the electrical impulses are so fast and chaotic, the atria
cannot contract and/or squeeze blood effectively into the ventricle. Since the blood
isn’t pumped out of the heart normally, blood can stagnate and it’s easier for the
blood cells to stick together and form clots in the left atrium, especially in an area
called the left atrial appendage (LAA). The LAA is about the size of your thumb and
looks like a small pouch on the top of your heart.
If a clot leaves the heart and travels to the brain, it can cause a stroke by
blocking the flow of blood through cerebral arteries. And therefore, they cut off
blood supply to parts of the brain and cause an ischemic stroke. Clots can also travel
to other parts of the body (kidneys, heart, intestines), and cause other damage. People
with atrial fibrillation are 5 times more likely to have a stroke than the general
population. In non-valvular AFib, the LAA is believed to be the source of most
stroke-causing blood clots.
The 2016 European Society of Cardiology (ESC) guidelines recommend
using the CHA2DS2-VASc score to estimate stroke risk in AF patients and to start
OACs in men with a score of 1 or higher and women with a score of 2 or higher. The
2014 American Heart Association/ American College of Cardiology/ Heart Rhythm
Society (AHA/ACC/HRS) guidelines also recommend the CHA2DS2-VASc score
for the assessment of stroke risk in patients with nonvalvular AF. Consideration of
OAC prophylaxis is recommended for patients with a score of 1 and OAC use is a
definite recommendation for patients with a score of 2 or greater and for those with
a history of stroke or transient ischemic attack.