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Do You Know the Warning Signs of A-Fib?

Fatigue, dizziness and shortness of breath could be pointing to a common heart condition

spinner image a heart with an irregular heartbeat pattern over it signifying atrial fibrillation or afib
Getty Images

The nagging fatigue, shortness of breath and feelings of dizziness were all new for Kareem Abdul-Jabbar. The basketball legend had spent decades running up and down the court, not to mention running up records. And here he was having trouble keeping up with his son on a European vacation.

“I've been an athlete all my life and kept in pretty good shape. I didn’t think that anything was capable of bothering me,” Abdul-Jabbar, 75, tells AARP.

While abroad, he dismissed the intermittent symptoms. Back at home, however, he couldn’t ignore them any longer. At a recent Los Angeles Dodgers game, Abdul-Jabbar became so overwhelmed by weakness that he collapsed into a trophy case and had to be taken to the hospital.

The diagnosis, the doctors told him, was atrial fibrillation, or A-fib, a quivering or irregular heartbeat that disrupts the flow of blood between the upper and lower chambers of the heart. If left untreated, the condition, most common among older adults, can lead to a host of heart-related complications, including blood clots, heart failure and stroke.

spinner image Kareem Abdul-Jabbar poses on an outdoor community basketball court
'It could be a major issue; it could threaten your life,' Abdul-Jabbar says on getting diagnosed with A-fib.
Courtesy of No Time To Wait campaign on behalf of Bristol Myers Squibb and Pfizer

Know the symptoms of A-fib

The fatigue, dizziness and shortness of breath that Abdul-Jabbar experienced are among the more common symptoms of A-fib, which affects at least 2.7 million Americans — a number that’s expected to jump to 12.1 million by 2030, according to the Centers for Disease Control and Prevention (CDC).

Others include fluttering in the chest, a rapid heartbeat, sweating, faintness or confusion, and chest pain or pressure. All of them can come and go.

“Some people might feel like their heart is pounding out of their chest,” says Jim Cheung, M.D., a cardiac electrophysiologist at Weill Cornell Medicine in New York City. Others, he adds, may exhibit more subtle symptoms, or even no symptoms at all.

“Sometimes it also affects moods,” says Mark Estes, M.D., professor of medicine at the University of Pittsburgh School of Medicine and a cardiologist at the UPMC Heart and Vascular Institute in Pittsburgh. “People may get a bit edgy [with] A-fib. So there’s a spectrum.”

With the warning signs all over the map, doctors say it’s not unusual for people to overlook A-fib symptoms when they first strike, or to attribute them to something else entirely. But doing so can be downright dangerous. 

For one, prolonged rapid beating of the heart brought on by A-fib can lead to heart failure, Cheung explains. Another big risk related to A-fib is stroke. When the upper chambers of the heart, known as the atria, are fibrillating and not contracting with a normal rhythm, blood can pool in the chamber and clots can form, Cheung says.

If a clot gets ejected and lodged in the brain or another part of the body, it can cause a stroke. “And so that is probably the most common and most potentially dangerous consequence of atrial fibrillation,” Cheung explains.

According to the CDC, the risk of stroke is five times higher for people with A-fib. With appropriate treatment, however, that risk “can be dramatically reduced, almost to zero,” Estes says.

12 risk factors for A-fib

  1. Advancing age
  2. High blood pressure
  3. Obesity
  4. European ancestry
  5. Diabetes
  6. Heart failure
  7. Ischemic heart disease
  8. Hyperthyroidism
  9. Chronic kidney disease
  10. Moderate to heavy alcohol use
  11. Smoking
  12. Enlargement of the chambers on the left side of the heart

Source: Centers for Disease Control and Prevention  

‘This is nothing to play around with’

If you experience any of the warning signs of A-fib, experts say it’s important to see a doctor. How quickly you need to see one depends on the severity of your symptoms, Estes says. Like Abdul-Jabbar, some patients “feel so poorly that they have to be evaluated in the emergency room." (This is especially the case for individuals who experience chest pain.) “But most patients [with more mild symptoms] can see their doctor within a day or two,” Estes adds.

It’s possible not to have any symptoms, but to first notice signs of A-fib from your smartwatch, fitness monitor or blood pressure cuff. (You’ll notice random spikes in your pulse reading.) Even without symptoms, it’s crucial to get evaluated.

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Medical tests such as an electrocardiogram (also known as an ECG or EKG) can confirm A-fib, and a menu of treatment options can help patients manage it. For example, there are blood thinners to prevent clots from forming and other medications like beta-blockers and calcium channel blockers to help control the heart’s rate and rhythm. Some people with A-fib may even benefit from surgery or other medical procedures.

“There is no one-size-fits-all,” Cheung says. “Even though it’s a very common arrhythmia, the way in which we treat it needs to be tailored for the individual patient.”

Lifestyle changes may also be part of the prescription. Getting regular exercise, losing weight and treating chronic health conditions like sleep apnea, diabetes and high blood pressure can help to minimize the burden of A-fib, Cheung says. The same goes for cutting out tobacco and cutting back on alcohol.

Since his diagnosis, Abdul-Jabbar says he’s working with his doctor to manage his A-fib. He’s also raising awareness around the importance of recognizing its symptoms and getting the appropriate care as the spokesperson for a new campaign called No Time to Wait.

“I want anybody that’s paying attention to me to understand that they need to go get those symptoms checked out. Don’t just assume that it’s a minor issue. It could be a major issue; it could threaten your life,” Abdul-Jabbar says. “This is nothing to play around with. Find out what’s going on in your body, and you will be doing yourself a favor.”​