Most people first notice an irregular heartbeat when they notice that their heart is pounding, "skipping a beat," or racing. Or a doctor may catch it when listening with a stethoscope. But it can be hard to know if this is an unusual episode or if you're experiencing signs of atrial fibrillation, a common, chronic condition that affects 3 million people in the U.S. If you suspect you have AFib, as it's often called, it's time to call the doctor, because AFib needs to be controlled to protect your health. Here are some of the health problems to watch out for -- and prevent with medical help -- if you suspect you have AFib.
Atrial Fibrillation Means Your Heart's Not Working Properly
Think of the heart as an electrical system that requires a steady, regular charge to keep beating normally. When this system becomes damaged, usually by some underlying condition such as high blood pressure, the signals get disrupted (or "disorganized," in doctor-speak) and the upper chambers of the heart, called the atria, begin quivering or "fibrillating" instead of pulsing regularly.
Why this is serious: When the atria fibrillate, vibrating rapidly and irregularly rather than pumping steadily, your heartbeat is weakened and blood doesn't move as quickly through the heart.
What to do: There are a number of treatment possibilities for AFib, depending on how and where the irregularity is happening, how severe it is, and the extent of the underlying damage. The doctor will order tests to analyze the heart's electrical signals (ECG) and look for structural damage and blood flow blockages (using electrocardiogram and X-ray). In 10 percent of AFib cases, no underlying cause is found, but the condition still needs to be treated.
Atrial Fibrillation Can Be a Sign of Coronary Artery Disease (CAD)
Buildup of fatty deposits in the arteries, called coronary artery disease or CAD, stiffens artery walls and slows the passage of blood to the heart. High blood pressure, which puts pressure on artery walls, both contributes to and is caused by CAD, so it must be treated as well.
Why this is serious: Over time, reduced blood flow can damage the walls of the heart's chambers and weaken the heart, leading to heart disease.
What to do: Control your cholesterol and high blood pressure with medications, and make lifestyle changes such as modifying your diet and increasing the amount you exercise to control the progression of coronary artery disease.
Atrial Fibrillation Can Lead to a Stroke
When the atria aren't working properly, the heart may not fully empty, allowing the blood to pool, where it can thicken and form clots.
Why this is serious: Blood clots can travel through the bloodstream to cause a stroke. Studies show that atrial fibrillation, particularly if it's not adequately treated, raises stroke risk five to seven times higher than usual.
What to do: Atrial fibrillation needs to be controlled with medications and procedures to regulate your heart rate and keep the blood moving. Blood thinners such as warfarin and aspirin are standard treatment for AFib, because thinning the blood reduces its ability to clot.
Atrial Fibrillation Increases Heart Attack Risk
The connection between AFib and heart attack is one of those chicken-and-egg cycles. Often AFib is caused by a heart attack, which damages the atria and upsets their ability to maintain a normal rhythm. However, AFib can also come first and contribute to heart attack risk.
Why this is serious: In AFib, the heart's electrical signaling system can get out of control, and a serious episode can trigger a heart attack. Also, AFib may signal underlying artery and heart disease, which raises heart attack risk.
What to do: Treatment for heart disease and heart attack prevention are both extremely important and should involve a cardiologist or an electrocardiologist, a specialist in heart rhythm problems. If medications don't sufficiently control AFib, your doctor may recommend a treatment to restore heart rhythm, such as radiofrequency ablation or cardioversion.
Atrial Fibrillation Can Leave You Tired and Weak
Because AFib can decrease the heart's pumping action by as much as 25 percent, it can lower the levels of oxygen in the blood.
Why this is serious: Oxygen feeds red blood cells, which are vital to strength and energy. When you feel tired and weak, it's a sign that your heart isn't working properly to keep blood flowing.
What to do: Typically, medication is the first-line treatment for AFib, and you'll likely need to take two or more medications to treat different aspects of the condition. But it can take time and teamwork to adjust medications to fully relieve symptoms. Your doctor will continue to check your heart rate and heart function to see that it's pumping as strongly as possible. He or she may prescribe a blood thinner to help more oxygen move through the blood as it flows more freely.
Atrial Fibrillation Can Cause Shortness of Breath
One of the best reasons to control atrial fibrillation is to prevent shortness of breath, which can restrict your activity level and impact your quality of life. If undertreated, atrial fibrillation discourages you from exercising and deprives you of the protective effects of exertion, which is important for overall cardiac health.
Why this is serious: Shortness of breath can lead to fatigue, weakness, and dizziness, which not only lower your spirits and impact your quality of life but can lead to falls. Also, shortness of breath and fatigue can lead you to cut back on exercise, even though exercise is extremely beneficial in heart disease prevention.
What to do: Your doctor should regularly administer stress tests to monitor your heart's action while you exert yourself. If you've cut back on exercise and fitness activities, talk to your doctor about more aggressive treatment to control these symptoms. And of course, this is one more big reason to quit smoking -- the habit contributes mightily to shortness of breath and heart disease.
Atrial Fibrillation Can Cause Sleep Problems
If your sleep is fitful, you wake frequently, or you still feel tired when you open your eyes in the morning, it's likely that atrial fibrillation or related health problems are impacting your sleep.
Why this is serious: Deep, restorative sleep is essential for healthy aging, as it affects pretty much every aspect of your body and brain. Also, research shows that adequate sleep helps prevent weight gain and poor eating habits, like relying on sweets and caffeine for quick energy.
What to do: You might notice that lying flat increases the symptoms of AFib; elevating your head and chest with pillows may help. Sleep apnea, a sleep breathing disturbance in which breathing halts longer than usual between breaths, occurs in many people with AFib. Sleep apnea can have a negative impact on overall health, including increasing your risk for heart attack and stroke, so ask your doctor about testing and treatment with a night-time CPAP device.
Atrial Fibrillation Can Cause Anxiety Attacks
When you feel a fluttering in your chest or your heart pounds, it's natural to feel worried. And sometimes people confuse tachycardia -- an overly fast heartbeat -- with a panic attack, even going to the emergency room.
Why this is serious: Anxiety and AFib have a tendency to get into a circular relationship. If you have AFib, you might find yourself worrying every time you experience symptoms -- which in turn can cause symptoms to get worse. Also, the feeling of being "keyed up" interferes with your sleep.
What to do: It's normal and understandable to feel anxious when you're experiencing AFib symptoms, and you should feel less worried as treatment takes effect and symptoms lesson. But if you continue to experience ongoing anxiety, discuss it with your doctor. Beta-blockers, often prescribed for high blood pressure, can have a calming effect, or your doctor can prescribe antianxiety medication along with your other meds. Meditation, yoga, deep breathing exercises, and other stress relievers are helpful for managing anxiety.
Atrial Fibrillation Can Cause a Fall
When your heart can't pump as strongly, the result is less oxygen in your blood, which can make you feel dizzy or weak, as though you were at high altitude.
Why this is serious: Dizziness associated with AFib tends to get worse with exertion, so you might find yourself feeling breathless and faint when walking, exercising, or working around the house, increasing your risk of falls and injury. If you're older, you're more likely to have balance problems, and falls are an even bigger concern because a broken hip or other injury can trigger a cascade of health problems.
What to do: Tell your doctor anytime you're feeling faint, dizzy, or unually fatigued. She'll probably want to adjust your treatment options to help maintain your strength. Also, it's a good idea to install grab bars and rails around the house to prevent dangerous falls.
Atrial Fibrillation Can Cause Edema
If you notice that your ankles, calves, or hands are puffy or shoes don't fit, this is a sign of fluid buildup. This is usually due to poor circulation.
Why this is serious: Fluid buildup can be a sign of more serious heart disease, such as heart failure, which occurs when not enough oxygen is reaching the heart and the heart muscle becomes damaged.
What to do: Tell your doctor if you notice any signs of fluid buildup, which would indicate that atrial fibrillation isn't being adequately controlled. It will help if you can explain when it's happening, and pay attention to any factors that might be contributing (such as eating a salty meal).