Have a high index of suspicion for XXXX .

@entity1 @entity64 @entity548 @entity591 @entity887 @entity955
The lifetime risk of @entity955 ( @entity955 ) for @entity1 and @entity1 over the age of 40 is about 25%. The condition affects around 800,000 @entity1 in the UK, of which it is estimated that 250,000 are undiagnosed. A rapid heart rate may result in palpitations, dyspnoea or chest tightness, whereas loss of atrial contractility may lead to fatigue and reduced exercise capacity. There is a five-fold increased risk of @entity64 , transient @entity887 . @entity955 strokes are larger, more disabling and have a higher mortality rate than those with other causes. The risk of @entity64 is not related to the presence or absence of symptoms, or whether the @entity955 is paroxysmal or persistent. When an irregular pulse is detected it should precipitate further assessment with a 12-lead ECG. In @entity1 with intermittent palpitations that may represent @entity955 , prolonged ECG monitoring can be used to increase the chance of diagnosis. In @entity1 with a confirmed diagnosis of @entity955 , three areas need to be considered, @entity64 risk, symptoms, and risk of @entity591 . The CHA2DS2-VASc score is used to assess the @entity64 risk in @entity1 with @entity955 . Oral anticoagulation should be offered to those with a CHA2DS2-VASc score of 2 or more, and considered for @entity1 with a score of 1. The risk of severe @entity548 with warfarin should also be assessed using the HAS-BLED score. A score of 3 or more indicates that caution is required when starting any anticoagulant therapy. Oral anticoagulant therapy can reduce the risk of @entity64 by around 50-70%. It should be started when the @entity1 reaches 65 or if he/she develops any of the risk factors for @entity64 .
