8 Symptoms Never to Ignore If You Have Atrial Fibrillation

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  • Atrial fibrillation (afib) increases your risk of stroke and heart attack, which means controlling it well with medications and lifestyle changes is essential to maintaining your quality of life. Afib can be challenging to manage, though, even with medications. To help you avoid atrial fibrillation complications, you should monitor your symptoms and be alert to signs of poorly controlled afib that should be addressed by your doctor—or may even require emergency medical intervention. To protect yourself from serious afib complications, know these atrial fibrillation signs and symptoms never to ignore.

  • 1
    Increasing Fatigue
    tired woman in bed

    Fatigue may represent the number one atrial fibrillation symptom. Many people with afib report fatigue, even when they’re not engaged in any physical activity. If you notice your fatigue level increasing even while you’re at rest, you should contact your doctor. Increasing fatigue levels can be a sign your atrial fibrillation is not well controlled. Your doctor may want to evaluate your heart to find out if afib is causing your increased fatigue, or if you have another cardiac condition like heart failure. Either way, early intervention can help you avoid further heart complications.

  • 2
    Increasing Breathlessness
    Older man out of breath while running

    Atrial fibrillation can make you feel short of breath because the heart’s erratic contractions can’t push enough oxygen-rich blood through your arteries. If you notice increasing episodes of breathlessness, especially when you’re lying down, it could be a sign your afib is no longer well controlled. See your doctor to find out if your treatment plan needs to be revised. Increasing breathlessness might also indicate a different cardiac condition, so this symptom deserves a thorough investigation to learn the cause.

  • 3
    Frequent Heart Palpitations or Pounding Heart
    Middle aged African America woman with chest pain

    People with atrial fibrillation often report sensations of a pounding heart or heart palpitations—as if the heart is skipping beats. Usually these symptoms resolve with medication therapy, but if you notice more frequent episodes of palpitations or a pounding or racing pulse, contact your doctor to find out if your afib is causing these symptoms. It’s possible your medication needs to be adjusted, or that you would benefit from some other therapy for afib.

  • 4
    Chest Pain, Discomfort or Pressure
    Woman on exercise bike out of breath

    Heart attack is a major potential complication of atrial fibrillation, so you should remain alert for any of the signs and symptoms of myocardial infarction. Chest pain, pressure and discomfort often herald a heart attack, but some people experience pain or discomfort in their back, neck or arm instead of in the chest. Difficulty breathing, sweating and nausea also might accompany a heart attack. If you experience heart attack symptoms, call 911 for immediate medical assistance.

  • 5
    One-Sided Weakness and Other Signs of Stroke
    Cropped image of female Caucasian patient holding stomach in pain being assisted by doctor

    Poorly controlled atrial fibrillation can allow blood clots to develop in the chambers of the heart. These clots then can make their way to the brain and cause a stroke. Anyone with afib should exercise constant vigilance for signs of stroke that include a drooping face, one-sided arm or body weakness, and slurring or other difficulty with speech. Stroke is a medical emergency that requires rapid intervention. Call 911 for anyone exhibiting signs of stroke, even if the symptoms seem to go away.

  • 6
    Lightheadedness
    Senior Caucasian woman with cane sitting outside feeling fatigue or dizziness

    If you experience feelings of lightheadedness with increasing frequency, it could indicate a progression of your afib. Keep a log of how often you feel faint, dizzy or lightheaded—and what activity you were engaged in when the episode occurred. If you notice a trend toward feeling dizzy more often, or if you find you frequently need to stop what you’re doing to sit down or otherwise address the lightheadedness, notify your doctor. Your treatment plan may need to be adjusted to better control your afib symptoms.

  • 7
    Persistent Low Blood Pressure
    Senior man controlling his blood pressure at home

    People with afib should monitor their blood pressure regularly, because pressure that trends downward could indicate an increase in fibrillation. Low blood pressure accompanied by other afib symptoms like shortness of breath or lightheadedness is especially concerning and warrants a call to your doctor. Extremely low blood pressure due to atrial fibrillation can cause a loss of consciousness, which represents a medical emergency. Call 911 immediately if someone with afib ever passes out, even if they regain consciousness quickly.

  • 8
    Uncontrolled Bleeding
    closeup bearded man with nosebleed using tissue

    Because most people with atrial fibrillation take anticoagulant (blood-thinning) medication, uncontrolled bleeding always represents a potential afib complication. Although bleeding is not a sign or symptom of afib, per se, anyone who takes an anticoagulant should be alert for uncontrolled internal or external bleeding. Call your doctor right away if you notice dark or pink-tinged urine, tarry stools, or bright red blood in the toilet. If you can’t get a wound or nosebleed to clot, maintain direct pressure on the wound and go to an urgent care center or the emergency room.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Oct 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Atrial Fibrillation. U.S. National Library of Medicine, MedlinePlus. https://medlineplus.gov/atrialfibrillation.html
  2. Atrial Fibrillation. U.S. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/atrial-fibrillation
  3. What are the Symptoms of Atrial Fibrillation (Afib or AF)? American Heart Association. https://www.heart.org/en/health-topics/atrial-fibrillation/what-are-the-symptoms-of-atrial-fibrillation-afib-or-af
  4. Afib Symptom Tracker. American Heart Association. http://myafibexperience.org/media/38150/8acb60f4956bf965cc2cb678da41a8f2-aha_afibtown_symptom_tracker_dl_v5_fillable.pdf