Internal Medicine

Symptoms of atrial fibrillation

introduction

Atrial fibrillation is a relatively common disease that is completely asymptomatic in many cases. So those affected do not notice anything about the disease. It is therefore not infrequently an incidental finding in the EKG. Symptoms mainly occur when the heart beats too fast or too slowly in the context of atrial fibrillation, but can also occur with atrial fibrillation with a normal heart rate (normofrequency atrial fibrillation) occur.

General information on this topic can be found at: Atrial fibrillation

All symptoms

Racing heart
Palpitations
Pressure on the chest
shortness of breath
shortness of breath
Anxiety
Feeling anxious
sweat
limited exercise capacity
dizziness

Irregular heartbeat

Atrial fibrillation is defined by an irregular heartbeat. This creates an electrical excitation in the area of the atrium, which is normally not present and which brings the heart out of step. The sinus node, which is normally the clock of the heart rhythm, is ignored, so to speak. Atrial fibrillation is therefore defined by an irregular heartbeat with the absence of the so-called P-wave in the ECG. This always occurs when a normal atrial excitation occurs via the sinus rhythm. This is no longer the case with atrial fibrillation. Many people do not even notice the irregular heartbeat. Often it only becomes noticeable when the heart beats too fast or too slowly. This can be shown by a feeling of racing heart or dizziness. Atrial fibrillation is seldom noticed as a stumbling of the heart; the feeling of stumbling occurs much more frequently when there are extra beats in the atrium that many healthy people have from time to time. It then feels like the heart skips a beat or beats twice too quickly. Even if patients with atrial fibrillation don't always notice the irregular heartbeat, they can check. By measuring the pulse. For this purpose, the index and middle fingers are placed on the area directly below the ball of the thumb. Here is usually the pulse of the Radial artery to feel. With atrial fibrillation, there is no regular throbbing felt here, but a disordered, arrhythmic pulse.

Palpitations / absolute arrhythmia / palpitations

Atrial fibrillation can cause symptoms such as the palpitations described above. More often, however, patients experience a racing heart when the atrial fibrillation is accompanied by a heartbeat that is too fast. If the heart beats too fast in the context of atrial fibrillation, one speaks of a tachycardiac atrial fibrillation or of a Tachyarrhythmia absoluta. The term absolute arrhythmia, on the other hand, only describes the irregular heartbeat without making a statement as to whether the heart rate is too fast, too slow or normal. In tachycardial atrial fibrillation, depending on how much the heart is beating too fast, the heart rate is uncomfortable. It can be accompanied by other symptoms such as excessive sweating, a feeling of shortness of breath even during light physical exertion, feeling of pressure or pain in the chest area, feeling of oppression and dizziness.

You might also be interested in this topic: Symptoms of Palpitations or Absolute Arrhythmia What You Should Know

Difficulty breathing with atrial fibrillation

Shortness of breath is a symptom that occurs primarily with atrial fibrillation, which is accompanied by a too fast heartbeat, tachycardiac atrial fibrillation (Tachyarrhythmia absoluta). With atrial fibrillation, the heart no longer pumps as effectively as a healthy heart. This means that less freshly oxygenated blood per minute is made available to the rest of the body. The faster the heart beats with atrial fibrillation, the more the pumping capacity is impaired and the less oxygen-saturated blood reaches the rest of the body. Therefore, a tachyarrhythmia absoluta with shortness of breath and shortness of breath (Dyspnea) accompanied. In most cases, this does not occur at rest, but under stress. Atrial fibrillation with a normal heart rate can also lead to premature shortness of breath during high physical exertion. The faster the heart beats in atrial fibrillation, the earlier the shortness of breath can occur. If the heart beats very quickly, even at rest you may be short of air.

Please also read: Shortness of breath

Loss of performance in atrial fibrillation

As described above, a heart with atrial fibrillation no longer pumps blood as effectively as a healthy heart. Less oxygen-saturated blood reaches the body periphery. This often does not cause any discomfort when the body is at rest. But it is precisely with greater physical exertion that it leads to shortness of breath and a drop in performance. The physical performance that could otherwise be achieved without any problems can suddenly become difficult. This is by no means the case for all patients with atrial fibrillation, but it is of course all the more noticeable when it comes to a patient who is often involved in sports. In most cases, the faster the heart beats in atrial fibrillation, the lower the physical performance. This is due to the fact that the heart pumps blood less and less effectively when the heartbeat is too fast.

Heart pain associated with atrial fibrillation

Atrial fibrillation can lead to symptoms such as a feeling of pressure on the chest or pain in the chest. These symptoms can mainly show up in patients in whom the atrial fibrillation occurs as a seizure (paroxysmal atrial fibrillation). The heart pain can then appear relatively suddenly. The most important differential diagnosis here is the heart attack. This is often accompanied by pain or pressure in the chest area, profuse sweating, nausea, and sudden shortness of breath. The distinction between a heart attack and a sudden onset of atrial fibrillation episode is therefore by no means always easy. Therefore, a doctor should be presented very promptly in the event of these complaints. The combination of ECG and determination of certain blood values allows a statement to be made as to whether it is heart pain in the context of a heart attack or atrial fibrillation.

You might also be interested in the following topic: Heart pain

Anxiety / restlessness with atrial fibrillation

Feelings of fear, anxiety and inner restlessness can also occur with atrial fibrillation. Again, these symptoms are more common in patients who have seizure atrial fibrillation. The symptoms can then start suddenly, out of nowhere. Patients with permanent atrial fibrillation are less likely to have these symptoms.

Dizziness with atrial fibrillation

Dizziness can appear as a symptom in patients with atrial fibrillation. It can occur in both atrial fibrillation with too fast and with too slow a heartbeat. The type of dizziness that occurs varies from patient to patient. More common is dizziness in patients with bradycardic atrial fibrillation / Bradyarrhythmia absoluta, i.e. atrial fibrillation with a heartbeat that is too slow. The slower the heart beats, the less blood is pumped into the rest of the body and the worse the brain is supplied with oxygen. This can lead to dizziness and, if the heartbeat is very slow, even to unconsciousness.

You might also be interested in this topic: Causes of dizziness

Sweating with atrial fibrillation

Sweating is a very non-specific symptom. It can occur in numerous diseases. It can also happen with atrial fibrillation. Symptoms such as rapid heartbeat, sweating and shortness of breath can suddenly occur, especially in patients with atrial fibrillation.

Also read: Excessive Sweating - What Causes It?

What are the symptoms of alcohol-induced atrial fibrillation?

In situations with unusually high alcohol consumption, atrial fibrillation can spontaneously develop. In addition, chronically high alcohol consumption significantly increases the risk of developing atrial fibrillation. The symptoms of atrial fibrillation caused by alcohol are no different from other atrial fibrillation. Even with atrial fibrillation triggered by alcohol, it is often the case that it is not even noticed. Especially episodes that are triggered by a fast and unusually high consumption of alcohol only last for a short time and then disappear again so that these are often neither noticed by the person concerned nor recorded by an EKG. More rarely, however, the typical symptoms such as palpitations, dizziness, increased sweating, feelings of fear and shortness of breath can occur.

Also read: Consequences of alcohol

Stroke risk with atrial fibrillation

Patients with atrial fibrillation have an increased risk of having a stroke. How high this risk is depends on the accompanying illnesses present. To assess the risk of stroke in patients with atrial fibrillation, there is a test called the CHA2DS2-Vasc score. This queries several illnesses and points are awarded if they are present. The higher the score, the higher the risk of stroke. The risk is divided into low, medium and high. The risk of suffering a stroke in patients with atrial fibrillation is about five times higher than in patients with healthy hearts. As a result, most patients need to take a blood thinner on a permanent basis to reduce the risk of stroke. Whether a blood thinner is necessary depends on the previous illnesses and age and is also determined by the CHA2DS2-Vasc score. The symptoms of a stroke can show up in completely different ways. Muscle paralysis (face, arms, legs), sensory deficits, speech disorders, sudden severe dizziness and many other possible symptoms can occur. A hospital must then be visited immediately.

Read also on this topic What is the life expectancy with atrial fibrillation?