In a patient with atrial fibrillation, what complication should be monitored for?

In patients with atrial fibrillation, the primary complication that must be closely monitored is the risk of thromboembolism leading to stroke. This condition is characterized by the chaotic electrical activity in the atria, which can lead to ineffective atrial contraction and blood stasis. When blood pools in the atria, particularly in the left atrial appendage, it increases the likelihood of thrombus (blood clot) formation.

If a thrombus forms and dislodges, it can travel through the bloodstream and potentially occlude cerebral arteries, resulting in an ischemic stroke. The risk of stroke in atrial fibrillation is significant, and patients are often placed on anticoagulation therapy to mitigate this risk.

While heart failure, pulmonary embolism, and myocardial infarction are important cardiovascular concerns that can occur in the context of various cardiac conditions, the unique pathophysiology of atrial fibrillation distinctly elevates the risk for thromboembolic strokes, making it the most critical complication to be aware of and monitor for in these patients.