What Your Racing Heart Might Mean: Symptoms of Atrial Fibrillation (A-fib)

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Worried that you or your loved one may be suffering from symptoms of atrial fibrillation? It's a reasonable concern: An estimated 3 million Americans have this common heart condition. If you have no previous diagnosis of atrial fibrillation (also known as A-fib), here's what to watch for and what to do:

Racing heartbeat

A fast resting pulse can be a sign of atrial fibrillation; doctors usually investigate resting pulses that are higher than 100 beats per minute. A heart rate that gets above 100 with mild exertion (such as walking across the room) should also be checked into.

What to do: Report a high resting heartbeat to a doctor promptly. If you have a home blood pressure cuff, be sure to report the blood pressure, along with the heart rate. Many other acute health problems, such as low red blood cell count and infection, can cause a high heart rate, so your doctor's response will depend on what other symptoms are present. Be sure to mention all symptoms.

What Your Irregular Heartbeat Might Mean

Irregular heartbeat

When the pulse is felt at the wrist or neck, beats may feel irregular, meaning that within 30 seconds or so, the time between beats is sometimes very short and other times longer. (Note: It's normal for the pulse to occasionally skip a beat or give a double beat, but most beats should be coming regularly.)

What to do: Report this irregular heartbeat to a doctor promptly. An ECG can determine if the irregular heartbeat is A-fib. If other symptoms such as shortness of breath, dizziness, or racing heartbeat are present, you should seek same-day medical care.

What Shortness of Breath Might Mean

Shortness of breath

A-fib can sometimes cause shortness of breath, especially if the A-fib causes the person to have a racing heartbeat. The shortness of breath is usually worse with exertion, such as when climbing stairs, and sometimes it's worse when the person lies flat in bed.

What to do: New shortness of breath should always be promptly reported to a doctor and usually requires same-day evaluation. Shortness of breath is a symptoms of many potentially serious illnesses, including pneumonia, COPD exacerbation, heart failure exacerbation, and coronary artery disease.

What Lightheadedness Might Mean

Light-headedness and/or fatigue

This symptom is usually a result of a racing heartbeat. The person may complain of feeling light-headed or tired, especially after walking or other physical exertion.

What to do: Check the person's pulse if you can, then report any new light-headedness or fatigue with exertion to a doctor promptly. If you have a home blood pressure cuff, it can be very helpful to report the person's blood pressure along with the pulse. Light-headedness can be caused by a variety of medical problems, so the doctor's response will depend on what other symptoms are present.

What Swelling of the Shins Might Mean

Swelling of the shins

A more unusual symptom, lower leg swelling can be caused by A-fib if the A-fib happens to provoke symptoms of heart failure in a susceptible person. In this case, the person also usually experiences some shortness of breath with exertion.

What to do: Check the person's pulse if you can, then report any new lower leg swelling to a doctor promptly.

For more on how A-fib is diagnosed, see FAQ How Is Atrial Fibrillation Diagnosed?

For more on how A-fib is managed, see Atrial Fibrillation (A-fib): Rhythm Control or Rate Control? and Atrial Fibrillation (A-fib) and Blood Thinners.


Dr. Leslie Kernisan

Leslie Kernisan is a clinical instructor in the University of California, San Francisco, Division of Geriatrics, and maintains a popular blog and podcast at BetterHealthWhileAging. See full bio