heart

Palpitations of the heart or uncomfortable sensations in the chest can be distressing. Thoughts of heart attack may come to mind, and that anxiety can only exacerbate the situation. While heart attack might be the first thing people think of when experiencing chest discomfort, atrial fibrillation may be to blame for such feelings. Atrial fibrillation, commonly referred to as aFib, is a quivering or irregular heartbeat that may lead to heart-related complications. The American Heart Association says that at least 2.7 million Americans are living with aFib. Although treatable, without proper diagnosis, AFib may lead to blood clots, stroke and even heart failure. Many people with aFib experience no symptoms at all and are unaware they have it until it is discovered during a physical examination. For those who experience symptoms, The Mayo Clinic lists these as some of the more common:

  • Palpitations, which can be sensations of a flip-flopping in the chest or even a racing feeling.
  • Fatigue
  • Reduced ability to exercise
  • Lightheadedness
  • Chest pain or shortness of breath
  • Dizziness and weakness

When the heart is working normally, it contracts and relaxes in a beat. When a person has aFib, the upper chambers of the heart, called the atria, beat irregularly. They quiver and do not move the blood into the ventricles in an effective manner. This irregularity can cause pooling or clotting of blood.

A proper diagnosis from a physician is needed before treatment can begin. An examination may include an EKG or ECG, which will show the heart's electrical activity as line tracings on paper. The spikes and dips in the tracings are called waves. An EKG will determine if the heart is pumping correctly.

AFib is more common among people with clogged arteries or diabetes and may develop following valve surgery. AFib also is more common in people with coronary heart disease. As a person ages, his or her risk for aFib increases. Stress can also be a major factor in triggering aFib, according to stopafib.org.

Once AFib is diagnosed, managing risk factors and restoring a heart to normal rhythm becomes the priority. Doctors use a variety of medications to control heart rate, which may include beta blockers and calcium channel blockers. Medications to prevent stroke also may be prescribed. Surgical intervention may be necessary if medications aren't working.

Screening for asymptomatic atrial fibrillation in people age 65 and over and treating it with anticoagulant medications could prevent many thousands of strokes worldwide each year, says a top-level panel of experts in Circulation, the journal of the American Heart Association.

An international collaboration, AF-SCREEN, is behind a global push to introduce national screening programs for the common heart condition afib.

Afib accounts for as many as one in three strokes. This happens because the abnormal heart rhythm can allow blood clots to form inside the heart. When clots break off they usually travel to the brain, causing severe strokes.

About 10 percent of ischemic strokes are caused by afib that is first detected at the time of stroke. Asymptomatic afib not uncommon and can be easily detected by simply taking the pulse, or by handheld ECGs that provide a diagnosis in less than a minute.

“Strokes from afib are larger, more severe, and harder to survive than other strokes,” says Mellanie True Hills, founder and CEO of StopAfib.org, an organization for people living with atrial fibrillation. “To be able to protect vulnerable people from ever experiencing one will spare them and their families a lot of heartache.”

Statistics from the World Heart Federation show 15 million people have a stroke each year, nearly six million die, and another five million are left permanently disabled.

“Widespread screening for asymptomatic atrial fibrillation in people aged 65 years and above could cost-effectively reduce strokes and their associated disability, and help save lives,” says Hills. “However, this is not yet widely recommended in guidelines.”

Screening has been shown to detect undiagnosed AF in one to three per cent of people aged over 65 to 75 years of age.

Those with concerns about their heartbeat and stroke risk can take action. “If you are aged 65 years or over, then you can see your doctor to check your pulse, or check your own at home to see if it’s regular like a clock,” she says. “If it’s irregular, you can have an ECG and get your afib diagnosed and medicated.”

Widespread screening for asymptomatic AF among people aged 65 years and over would be a potent way to prevent strokes and the burden of stroke-related harm because afib-related strokes are largely preventable by treatment with oral anticoagulant drugs.

Learn more about screening at the AF-SCREEN International Collaboration website www.afscreen.org.

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