Mohanty Satyapriya, Banerjee Anindya, Kumar Abhinav, Deb Pranjit, Samantray Humshika, Das Debasish
Cardiothoracic Surgery, All India Institute of Medical Sciences (AIIMS) Bhubaneswar, Bhubaneswar, IND.
Cardiology, All India Institute of Medical Sciences (AIIMS) Bhubaneswar, Bhubaneswar, IND.
Cureus. 2023 Mar 30;15(3):e36918. doi: 10.7759/cureus.36918. eCollection 2023 Mar.
The development of atrial fibrillation adds a lot to the morbidity and mortality of individual patients. The spectrum of non-valvular atrial fibrillation among young adults is less known. The present observational study aims to analyze the clinical-aetiological spectrum of non-valvular atrial fibrillation among young adults between 18 and 40 years of age.
A retrospective observational study was carried out to analyze the clinical-aetiological spectrum of non-valvular atrial fibrillation among young adults less than 40 years of age attending the cardiac outpatient department in a tertiary care hospital in Eastern India over a period of two years. Patients with any form of organic valvular heart disease and patients more than 40 years of age were excluded from the study. One hundred and seventeen patients under 40 years of age were analysed with respect to demographic, aetiological, and clinical profiles.
Most common aetiologies behind non-valvular atrial fibrillation in young adults (<40 years) were hypertension (40%) and the presence of left ventricular systolic dysfunction (31%). Thyrotoxicosis, obesity, obstructive sleep apnoea, the presence of congenital heart disease, coronary artery disease, myopericarditis, chronic kidney disease, dyselectronemia, diabetes mellitus, and the presence of chronic obstructive pulmonary disease contributed towards the development of non-valvular atrial fibrillation in the young population in less proportion of cases. Most of the cases were symptomatic with palpitation, shortness of breath, or diaphoresis. Less number of cases (17%) had left atrial thrombus which may be due to early clinical attention with the proper therapeutic anticoagulation regimen.
Hypertension and the presence of left ventricular systolic dysfunction contribute to the majority towards the development of non-valvular atrial fibrillation among young adults. Accurate measurement and monitoring of blood pressure among young adults and careful assessment of left ventricular systolic dysfunction with subsequent appropriate management of hypertension and left ventricular systolic dysfunction in young can decrease the burden of non-valvular atrial fibrillation among the young population.
心房颤动的发生显著增加了个体患者的发病率和死亡率。年轻成年人中非瓣膜性心房颤动的情况鲜为人知。本观察性研究旨在分析18至40岁年轻成年人中非瓣膜性心房颤动的临床病因谱。
进行一项回顾性观察性研究，以分析在印度东部一家三级护理医院心脏门诊就诊的40岁以下年轻成年人中非瓣膜性心房颤动的临床病因谱。研究排除了患有任何形式器质性瓣膜性心脏病的患者以及40岁以上的患者。对117名40岁以下患者的人口统计学、病因学和临床特征进行了分析。
年轻成年人（<40岁）中非瓣膜性心房颤动最常见的病因是高血压（40%）和左心室收缩功能障碍（31%）。甲状腺毒症、肥胖、阻塞性睡眠呼吸暂停、先天性心脏病、冠状动脉疾病、心肌心包炎、慢性肾脏病、电解质紊乱、糖尿病以及慢性阻塞性肺疾病在较少比例的年轻人群中导致非瓣膜性心房颤动的发生。大多数病例有症状，表现为心悸、呼吸急促或出汗。较少病例（17%）有左心房血栓，这可能是由于早期临床关注并采用了适当的治疗性抗凝方案。
高血压和左心室收缩功能障碍在年轻成年人中非瓣膜性心房颤动的发生中占主要原因。对年轻成年人进行准确的血压测量和监测，并仔细评估左心室收缩功能障碍，随后对年轻患者的高血压和左心室收缩功能障碍进行适当管理，可以减轻年轻人群中非瓣膜性心房颤动的负担。
