Pathology - Multifocal Atrial Tachycardia
Pathophysiology This disorder develops when the right atrium contracts at several locations other than the SA node. Many of these atrial beats, in contrast to PACs, are routed through the AV node, which raises the ventricular rate by as much as 200 beats per minute at times. If insufficient ventricular filling is caused by the tachycardia, symptoms and hemodynamic instability may arise. Cardiomyopathy can also result from the heart's increasing strain, particularly in patients who also have other long-term medical conditions. Patients with medical illnesses including COPD, lung cancer, bacterial pneumonia, or pulmonary embolism that diminish blood oxygen content are more likely to have MAT than individuals who are younger than 50. The best way to treat MAT is to assess and address any underlying medical issues. Forceful atrial contraction against a noncompliant left ventricle is the cause of the S4 heart sound heard in this patient, which is a common finding in COPD patients. The patient's prolonged systemic hypertension contributes to increasing afterload on the left ventricle, which eventually becomes hypertrophied and noncompliant.
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