By Benita Philip, DO
The beat of your heart can tell you a lot.
It may race on your way to a first date. It can speed up when you’re too stressed or have had too much coffee. Or maybe it slows down during a blissful visit to the spa.
Changes in the heart’s rate may accompany many situations in life, and everyone experiences them from time to time.
But changes in heart rhythm may indicate a problem and shouldn’t be ignored.
Understanding Arrhythmias
In a healthy heart, electrical signals coordinate a steady heartbeat, but changes or disruptions in the heart’s electrical system can cause an irregular heartbeat, known as an arrhythmia.
Two of the most common types of arrhythmias are atrial fibrillation (Afib) and the related atrial flutter, which differ based on where in the heart’s electrical system the irregularity originates.
Both may cause similar symptoms that can be occasional, persistent or permanent, and both can reduce the heart’s efficiency, which in turn may affect blood flow to the rest of the body.
Even if symptoms occur only occasionally, it’s important to talk to your doctor if you’re experiencing any of the signs of arrythmia.
Common Warning Signs
Afib and atrial flutter do not always cause noticeable symptoms, but when symptoms do occur, they may include:
- Palpitations or a fluttering sensation in the chest.
- Shortness of breath.
- Fatigue or feeling faint.
- Chest pain, which may worsen with exertion (particularly in Afib).
If you notice any of these symptoms, especially if they persist, make an appointment to see your healthcare provider.
In patients with few or no symptoms, arrhythmias may be discovered only after a routine electrocardiogram (EKG) or while the patient is hospitalized and on a heart monitor.
The Dangers of an Irregular Heartbeat
Afib and atrial flutter can increase the risk of stroke, heart failure and other heart-related complications.
If blood isn’t moving regularly, it can become stagnant in the heart and form a clot, which at the next heart beat can travel to your brain, where it can block blood flow and lead to a stroke.
In fact, people with Afib are five times more likely to experience a stroke than those without Afib, according to the American Heart Association, even if they have no noticeable symptoms.
It’s important to note, however, that people have different risks for forming clots depending on their age, gender and other health conditions and should review those risks with their doctor.
In addition to blood clots, a rapid heartbeat caused by Afib and atrial flutter can also weaken the heart over time, leading to heart failure.
Who’s at Risk?
Though arrhythmias can affect adults of all ages, certain factors can increase the risk, including:
- Heart disorders.
- Coronary artery disease.
- Hypertension.
- Chronic conditions, such as diabetes; kidney, lung or thyroid disease; and sleep apnea.
- Excessive caffeine, alcohol or stimulants.
- Some medications and supplements.
- Inflammation or illness.
- Obesity.
- Electrolyte imbalance.
- Nicotine use.
Diagnosis and Treatment Options
Your healthcare provider can diagnose Afib and atrial flutter with a physical exam and confirmatory EKG, a quick and pain-free test to measure the heart’s rhythm. They may also refer you to a cardiologist or electrophysiologist (a heart rhythm specialist) for further evaluation.
In some cases, the cardiologist may recommend further testing with a Holter monitor, which is a wearable heart monitor to record the heart’s rhythm and rate during daily activities.
Treatment approaches vary depending on the specific diagnosis and may include medications to slow the heart or normalize heart rhythm, using cold or heat energy (ablation) to disrupt electrical signals, and/or mild shock therapy (cardioversion) to reset the heart rhythm.
Steps to Protect Your Heart
There are several steps you can take to keep your heart healthy and reduce your risk for heart disease, which can also help reduce your risk for Afib and atrial flutter:
- Exercise regularly. The American Heart Association recommends getting at least 150 minutes of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least two days per week.
- Eat a healthy diet that includes plenty of fruits and vegetables, fiber-rich whole grains, fish, nuts, legumes and seeds. Choose lower fat dairy products and foods low in saturated fat, trans fat and sodium. Limit red meat and sugar, including sweetened beverages.
- Do not smoke and avoid secondhand smoke. The dangers of smoking are well known, and even exposure to secondhand smoke increases a person’s risk of heart disease.
- Limit alcohol and caffeine. Both alcohol and caffeine can trigger irregular heart rhythms, especially if consumed in excess.
- Manage stress. Sustained stress increases heart rate and blood pressure and can damage artery walls. Methods for managing stress include mindfulness, breathing exercises, or making time for hobbies and activities you enjoy, among others.
- Get annual physicals. Schedule a routine physical each year and have your blood pressure and blood sugar level checked as well as other heart-health screenings. Talk with your doctor about additional tests or concerns, including if you snore, to rule out sleep disorders such as sleep apnea.
- Manage chronic conditions. High blood pressure, high cholesterol and diabetes can all contribute to heart disease. Be sure to follow your doctor’s instructions, including taking medication as prescribed, to manage these conditions and keep your numbers in healthy ranges.
Afib and atrial flutter can both cause serious risks if not diagnosed and treated appropriately. Recognizing the symptoms and seeking care can help prevent complications like stroke and heart failure.
If you are diagnosed with Afib or atrial flutter, work closely with your cardiologist to find a treatment plan that is right for you and adopt healthy habits to keep your heart beating regularly.
To find a physician affiliated with Penn Medicine Princeton Health, 1 (888) 742-7496 or visit www.princetonhcs.org.
Benita Philip, DO, is a cardiologist and a member of Penn Medicine Princeton Health Medical Staff.
