Dear Dr. Garner,
Last week while walking on Kings Highway, I became short of breath. My heart started to race, and I went by ambulance to the hospital. I have never before had anything like this happen to me.
I am a 54-year-old man who has always been in good health. I work out every day.
The doctors told me I had atrial fibrillation. My heart rate went back to normal in the emergency room, and I was discharged.
Could you please tell me what you think could have caused this? I am afraid this will happen again.
Fibrillating Fellow in Flatbush
Dear Fibrillating Fellow,
Atrial fibrillation can create a scary situation for people. Many describe it as a feeling of fright or panic, and they think they might be having a heart attack. Others feel as if death is going to ensue. In fact, while it feels scary and all of the above, in many instances, it is not usually life-threatening.
Let’s first discuss what the condition is. The heart has four chambers. The two on top are known as the atria, and the two on the bottom are the ventricles. When things are going well, the four beat in harmony. In atrial fibrillation, the top chambers beat too quickly, which, in turn, causes the bottom ones to beat too quickly. A person may feel short of breath or even chest pain as enough blood and oxygen do not circulate.
Different Ages, Different Causes
In young people, the condition can often be caused by lack of sleep, alcohol or smoking. In older people, the possibility of abnormalities in the electrical conducting system of the heart must be considered.
To help evaluate this condition, there are a number of tests your doctor may use. The most important is a simple electrocardiogram, or EKG, which is the easiest way to diagnose the problem. Also, a sound wave test, known as an echocardiogram, may be used to help determine if the chambers of the heart are beating properly. There are other recording devices your doctor can use to evaluate the way the heart is beating over the course of several days.
Atrial fibrillation is the most common type of abnormal heartbeat. As people age, the incidence of atrial fibrillation increases.
The common symptoms that one might experience include irregular or rapid heartbeat, palpitations, lightheadedness, fatigue, shortness of breath and chest pain.
As in most areas of medicine, there are many different options available, and you and your doctor can decide what is best for you.
Your doctor may use medications to slow down the heart and bring it to a normal rhythm. Surgery may also be an option.
Sometimes atrial fibrillation can be controlled with lifestyle changes. Poor sleep habits, too much caffeine and too much alcohol can often be the culprits. Anxiety and tension may also be causative factors. Controlling obesity is often a very important part of treatment.
Atrial fibrillation may be present all the time or may occur occasionally. It is important to see your doctor in either case to help prevent severe complications, namely strokes and heart failure.
Before seeing your doctor, jot down the symptoms you are experiencing, and note if they are related to anything you might be doing at the time, such as exercising, smoking or experiencing a lot of anxiety. This will be very helpful to your doctor.
Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.