Ask The Experts: What Causes Fluttering In My Chest?
Dr. Soo Park, MD, a board-certified cardiologist with Franciscan Physician Network Indiana Heart Physicians in Indianapolis and Columbus, Indiana, answers your questions and shares expert insight on heart conditions.
Q. Sometimes I feel a fluttering in my chest. This sensation happens when I'm active - walking outside and when I'm resting - indoors watching TV. What could be the cause of this?
A. What you are describing is the classic symptom of atrial fibrillation or AFib. AFib is a condition characterized by a disrupted heartbeat. A malfunction in the electrical system of the heart makes the upper chambers of the heart (called the atria) beat so quickly that they twitch or skip beats. This, in turn, causes the heart's lower chambers, or ventricles, to beat in an uncoordinated way. The resulting irregular beats cause a fluttering heart rate that beats much faster than normal.
During episodes of AFib, some people can have symptoms while others may not even notice. What is important, though, is for people with AFib to be on blood thinners because of the increased risk for a stroke. Because of the irregular heartbeat, blood may pool in the atria and cause a clot. These clots can in turn, break loose and lead to a stroke which is the greatest danger of AFib.
The causes of AFib are usually related to other conditions that increase the level of stress placed on the heart. These might include
- High blood pressure
- Heart attack or coronary artery disease
- Heart failure
- Heart valve irregularities
- Sleep apnea
Less common causes might include a thyroid disorder or a severe infection like pneumonia.
Q. What Do I Do If I Think I Have AFib?
A. If you suspect AFib, the first step is to contact your primary care doctor. Your doctor is likely to order an electrocardiogram (EKG). An EKG is used to detect heart rhythm problems by recording the heart's electrical activity. EKGs can be completed in the doctor's office or can be conducted over the course of one or two days with a continuous rhythm, or Holter, monitor worn on the body.
If your symptoms are mild or if they come and go, medication can be used to control AFib. There are heart-rate controlling medications, which slow a rapid heart rate so the heart can pump more effectively, and there are heart-rhythm controlling meds which slow the electrical signals and bring the heartbeat into a normal rhythm. It’s also important to begin a daily routine of blood thinners, or anticoagulants, to help prevent blood clots from forming. Your doctor will talk with you about your best options for blood thinning.
Q. What If Medications Aren't Helping My AFib?
A. If medications don't bring your symptoms under control, there are procedures available that may help such as cardioversion, catheter/surgical ablation options. Cardioversion involves a mild electric shock which resets the heart’s rhythm. Ablation consists of burning off small parts of the heart that contribute to the abnormal beats. The resulting scar tissue blocks the abnormal electrical signals.
Q. Are There Other Things That Can Help Control AFib?
A. The good news is that there are steps you can take in your daily routine to eliminate potential AFib triggers. These include:
- Restricting fat, salt and sugar in your diet
- Reducing use of alcohol and caffeine
- Stopping tobacco use
- Controlling your weight
- Treating sleep apnea
- Avoiding medications like cough and cold medicine that contain stimulants that make the heart beat faster.
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