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Could I have atrial fibrillation without having symptoms?

Dr. Michael Roizen, MD
Internal Medicine
YES! You would think it would be hard to miss if your heart suddenly started beating like it was doing an extended jazz drum solo, but you may not be bothered. Atrial fibrillation may not cause noticeable symptoms in everyone. In fact, many patients find out that they have atrial fibrillation during an annual physical exam when a doctor conducts a routine physical or performs an electrocardiogram (ECG).
Mark Moronell, MD
Cardiology (Cardiovascular Disease)
Transesophageal echocardiography is a method that can diagnose, or identify the risk for, atrial fibrillation or blood clots in your heart. Atrial fibrillation is a common type of irregular heartbeat, or arrhythmia, that causes the heart to beat rapidly and unevenly. Normally, an echocardiogram test is done to evaluate your heart muscle or heart valve function as a potential cause for an arrhythmia. But because the heart's upper chambers -- or atria -- are deep within your chest, an echocardiogram may not show if the heart is fibrillating or abnormally quivering, or if there are blood clots present.

 Another option is for your doctor to do a transesophageal echocardiogram test to take a closer look at your heart through your food pipe, or esophagus. He or she will attach a transducer to the end of a tiny, flexible tube. The tube is guided down your throat to the esophagus. Using this instrument, your doctor can get accurate pictures of the heart and its atria to evaluate the presence of clots in the heart chambers or to assess communication between the right and left sides of your heart.
Douglas E. Severance, MD
Family Medicine
Atrial fibrillation, which is a rapid, irregular heartbeat, does not always cause noticeable symptoms. Many people with this disorder feel heart palpitations or suffer shortness of breath during physical activity or even chest pain. But others have no symptoms at all; they don't know they have a problem until they have a physical exam and their doctor detects the abnormal heart rhythm. Other people with atrial fibrillation go to their doctor because they are fatigued or have difficulty catching their breath. They think they have a cold or asthma and are surprised to learn they have a heart disorder.

To diagnose atrial fibrillation, your doctor will listen to your heart and check your pulse rate. If an electrocardiogram (ECG or EKG) test does not find atrial fibrillation while you're in the medical office, you may have to wear a Holter monitor for 24 to 48 hours at home to detect the abnormal heartbeat.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.