Atrial Fibrillation (AFib): Symptoms, How It Is Found and Why Follow-Up Matters

What it involves

MedlinePlus describes atrial fibrillation as a common abnormal heart rhythm in which the upper chambers of the heart contract in a chaotic way, producing a very irregular rhythm that is usually too fast. It is closely related to atrial flutter, and the two often occur in the same person.

Who this is for

• Patients who feel a racing, fluttering or irregular heartbeat, especially if it comes and goes
• Patients with high blood pressure, an overactive thyroid or heart disease who want a rhythm check
• Patients who feel dizzy, short of breath or unusually tired along with a fast pulse
• Patients already told they have AFib who need ongoing primary care follow-up

What to expect

• Questions about when the symptoms occur, how long they last and what you were doing
• Listening to the heart, checking the pulse and blood pressure, and a look at your medicines and alcohol use
• An in-office EKG at the Loxahatchee and West Palm Beach offices, and blood work such as thyroid tests
• A plan that may include a monitor, a medicine review and a referral to a cardiologist

What happens inside the heart

MedlinePlus explains that in a healthy heart, electrical signals from the sinus node direct the four chambers to contract in an organized sequence. In AFib, those signals become irregular, so the two upper chambers quiver instead of squeezing, and the lower chambers beat irregularly and often too fast. The heart may then be unable to pump enough blood for the body's needs. The encyclopedia adds that AFib becomes more common with age and affects both men and women.

Symptoms, and the fact that some people have none

Some people do not feel anything unusual. When symptoms appear, MedlinePlus lists a pulse that feels rapid, racing, pounding, fluttering or irregular, the sensation of palpitations, dizziness or lightheadedness, fainting, fatigue, weakness, less ability to exercise, shortness of breath, sweating and confusion. Chest pain or pressure may signal a heart attack, and the source says to call 911 right away. Palpitations in general are covered in the heart palpitations guide, and the fainting guide covers passing out.

How AFib is found

A provider may hear a fast heartbeat through a stethoscope, and MedlinePlus says the pulse may feel fast, uneven or both. The normal resting rate is 60 to 100 beats per minute, and in AFib or flutter the rate may be far higher. An ECG, which records the heart's electrical activity, may show the rhythm. This practice offers in-office tests at Loxahatchee and West Palm Beach, described on the EKG and heart health screening page. If the rhythm comes and goes, a wearable monitor from a specialist may be needed.

Causes and risk factors

The encyclopedia lists common causes: alcohol use, especially binge drinking, coronary artery disease, a prior heart attack or bypass surgery, heart failure or an enlarged heart, heart valve disease, high blood pressure, certain medicines, an overactive thyroid and pericarditis. Because blood pressure and thyroid problems are common contributors, a primary care visit often involves both. The hypertension management page and the thyroid care page explain how those are followed, and the heart disease risk guide covers the bigger picture.

Why treatment focuses on stroke prevention

MedlinePlus says the irregular rhythm of AFib makes blood clots more likely to form, and a clot that travels to the brain can cause a stroke. For that reason, most people with AFib need a blood thinner, though blood thinners raise bleeding risk, so not everyone can use them. Other treatments include daily medicines to slow the rate or keep the rhythm normal, cardioversion, and a procedure called ablation. Those belong to a cardiologist. Primary care helps find the problem, manage the conditions behind it and coordinate care.

When to call 911

Chest pain or pressure, fainting, severe shortness of breath, or sudden weakness, facial droop or trouble speaking with a fast or irregular pulse all call for 911, not a clinic visit. The chest pain guide explains where the line falls. For a heartbeat that is merely noticeable and comes and goes, MedlinePlus simply says to contact your provider if you have symptoms of AFib or flutter. AFib tends to return and can get worse over time, so follow-up matters.

Sources

• MedlinePlus — Atrial fibrillation and atrial flutter
• MedlinePlus — Atrial Fibrillation (health topic)