You may or may not notice atrial fibrillation. It often occurs with no signs or symptoms. If you do have symptoms, you may notice something that occurs only occasionally. Or, your symptoms may be frequent or serious. If you have heart disease that is worsening, you may notice more symptoms of atrial fibrillation. If your atrial fibrillation is undetected or left untreated, serious and even life-threatening complications can arise. They include stroke and heart failure.
The most common symptom of atrial fibrillation is fatigue. Other signs and symptoms include:
- Heart palpitations
- Difficulty breathing, especially when lying down
- Chest pain
- Hypotension, or low blood pressure
- Dizziness or fainting
Keep track of when and how often your symptoms occur, what you feel, and whether these things change over time. They are all important clues for your doctor.
When it is undetected or untreated, atrial fibrillation can lead to serious complications. This is especially significant for African Americans. Even though whites have atrial fibrillation at higher rates, research has found that many of its complications—including stroke, heart disease, and heart failure—are more common among African Americans. Some complications of atrial fibrillation include:
- Blood clots. With atrial fibrillation, the heart may not be able to pump the blood out properly, causing it to pool and form an abnormal blood clot in the heart. A piece of the clot—a type of embolus—can break off and travel through the blood to different parts of the body, blocking blood flow to the brain, lungs, intestine, spleen, or kidneys. Atrial fibrillation may also increase the risk of venous thromboembolism, which is a blood clot that forms in a vein.
- Cognitive impairment and dementia. Some studies suggest that impaired cognition, Alzheimer’s disease, and vascular dementia occur more often among people with atrial fibrillation. This may be due to blockages in the blood vessels of the brain or reduced blood flow to the brain.
- Heart attack. The risk of a heart attack from atrial fibrillation is highest among women and African Americans and especially in the first year after atrial fibrillation is diagnosed.
- Heart failure. Atrial fibrillation raises your risk of heart failure because the heart is beating fast and unevenly. The heart’s chambers do not fill completely with blood and cannot pump enough blood to the lungs and body. Atrial fibrillation may also make your heart failure symptoms worse.
- Stroke. If an embolus travels to the brain, it can cause a stroke. For some people, atrial fibrillation has no symptoms, and a stroke is the first sign of the condition. If you have atrial fibrillation, the risk of a stroke is higher if you are a woman.
- Sudden cardiac arrest. With atrial fibrillation, there is an increased risk that the heart may suddenly and unexpectedly stop beating if you have another serious heart condition.