When Your Heart Beats to a Different Drummer

By Kathy Hubbard

 
It’s supposed to go lub dub, lub dub but if it goes lub, lub dub or dub dub dub lub it could be atrial fibrillation. A patient at American Heart Association said, “My heart flip-flops, skips beats, and feels like it’s banging against my chest wall, especially if I’m carrying stuff up my stairs or bending down.”
Another said, “I was nauseated, light-headed, and weak. I had a really fast heartbeat and felt like I was gasping for air.” They were both diagnosed with atrial fibrillation, a common type of heart arrhythmia. Arrhythmia is when your heart beats too fast, too slowly or just irregularly.
“When a person has atrial fibrillation (AF or Afib) the normal beating in the upper chambers of the heart (the two atrial) is irregular and blood doesn’t flow as well as it should from the atria to the lower chambers of the heart (the two ventricles). AFib may occur in brief episodes or it may be a permanent condition,” The Centers for Disease Control and Prevention explains.
An estimated 2.7 to 6.1 million people in the U.S. have AFib. And, as we all get older the number is expected to increase. The CDC says that approximately two percent of people younger than age 65 have AFib while about nine percent of people over 65 have it.
“Because AFib cases increase with age and women generally live longer than men, more women than men experience AFib,” CDC says. But, anyone suffering high blood pressure, sleep apnea, congenital heart defects, lung diseases, and obesity are at risk.
Other causes can include heart attacks, coronary artery disease, an overactive thyroid gland or other metabolic imbalance, use of certain medications, caffeine, tobacco or alcohol, previous heart surgery, viral infections, stress due to pneumonia, surgery or other illnesses and heredity.
AHA says that common symptoms are general fatigue, rapid and irregular heartbeat, fluttering or “thumping” in the chest, dizziness, shortness of breath and anxiety, weakness, faintness or confusion, fatigue when exercising, sweating, chest pain or pressure.
They put an asterisk on chest pain: “*Chest pain or pressure is a medical emergency. You may be having a heart attack. Call 9-1-1 immediately.”
The symptoms are generally the same for the five different types of AFib, but the underlying reasons for the condition help medicos classify the problems. AHA describes these classifications:
“Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
“Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
“Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
“Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
“Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.”
The two most serious risks of AFib are stroke and heart failure. If you have any of the above symptoms you definitely need to make an appointment with your primary care provider right away. AFib can also lead to chronic fatigue, additional heart rhythm problems, and inconsistent blood supply.
Your PCP will most likely send you for diagnostic imaging. All of these tests can be performed at Bonner General Health. They include an electrocardiogram, a holter monitor (which is a portable electrocardiogram that tracks your heart’s activities for 24-hours or more), or an event recorder (which is also portable and tracks your heart activity for weeks or months which you activate when having an episode.)
You might have an echocardiogram, most certainly will have blood tests, perhaps a nuclear medicine cardiac stress test and chest x-ray. All these tests will give your medical team the information they need to determine the recommended treatment.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at [email protected].