Why diagnosis can be complicated – and what you can do to help
The symptoms of atrial fibrillation or AFib are well-known: a fluttering feeling that can point to a quivering heart muscle, the notable skipped beat that’s the mark of a palpitation, and a racing heart rate that sparks other discomforts. But how distinct are these symptoms? Could they be mistaken for another disorder?
The short answer is yes, they can. Moreover, atrial fibrillation sometimes brings such mild symptoms that patients don’t give them a second thought. In either case, you could be in danger, since living with undiagnosed and uncontrolled AFib can lead to a host of complications, including stroke.
How is AFib usually diagnosed?
Diagnosis begins with an honest and in-depth consultation with your doctor. They’ll want to know about your symptoms: what sort of discomforts are you experiencing? How often do they strike? How long does an episode typically last? Once they’ve got your account, they’ll consider your medical history, and then explore further with some targeted testing.
Some of the most common tests include:
Electrocardiogram. A reliable and non-invasive heart test, the EKG (or ECG) is a primary clinical tool for diagnosing AFib. Now, you can use the same technology outside of the doctor’s office.
Check pulse, blood pressure, and lungs. Typically, this is one of the first things your doctor will do to rule out other conditions that could be masquerading as a heart rhythm disorder.
Stress testing. Also known as exercise testing, a stress test involves measuring how your heart behaves during cardiovascular exercise. This could take place on a treadmill or another cardio machine.
Holter monitor or event monitor. Portable EKG devices can help detect AFib that comes and goes, also called paroxysmal AFib. You would wear these sorts of monitors on your body for a longer stretch of time to catch and record an AFib event.
It’s important to know that no test is a guarantee and AFib can be missed, go undetected, or be misdiagnosed for years.
Why is AFib misdiagnosed?
Clinical tests are often effective – but not always. In other cases, it’s not the test that fails, but rather a misinterpretation of the test results.
EKGs are helpful, but even computers can make mistakes. Sometimes the computer algorithm misinterprets something as an AFib event when in fact it’s not. If a doctor doesn’t catch this mistake when they interpret the test results, a patient can be misdiagnosed with AFib. This phenomenon is also known as fake atrial fibrillation, and it’s a growing concern in the medical community.
There’s also a genetic component to AFib: your chances of developing the disorder are higher if a close relative has been diagnosed with AFib. This is why relaying an accurate and complete family history is so important for the right diagnosis. If you’re not clear on your family medical history, or a family member has been living with AFib without realizing it, your doctor might be missing a crucial piece of the puzzle.
What conditions are commonly confused with AFib?
Medical conditions often occur alongside each other, which can complicate diagnosis. Since AFib symptoms and discomforts can be so subjective, it’s not uncommon for AFib to be mistaken for these other health problems:
Tachycardia and other arrhythmias. Tachycardia – an abnormally rapid heart rate – can disguise itself as AFib, because it’s often a symptom of AFib. Tachycardia can come from an infection, heart disease, congenital abnormalities, or a number of other causes, and can easily be mistaken for persistent AFib.
Anxiety or panic attacks. Anxiety and AFib go hand-in-hand for many people. The two conditions tend to feed off each other, causing a cycle of anxiety, tension, and chest discomfort. But an anxiety attack itself can manifest in the same fashion as an AFib episode, which can trick you into thinking your heart is in distress: panic attacks can come out of nowhere, and hit hard with symptoms like palpitations, muscle tension, lightheadedness, and even some chest pain.
Hyperthyroidism (Graves disease). Thyroid trouble can have whole-body consequences. When you have an overactive thyroid (clinically known as hyperthyroidism), your metabolism goes into overdrive and your heart rate can rise. In addition to your racing heart rate and palpitations, have you been losing weight without trying to? If so, your thyroid may be to blame. Your risk of both hyperthyroidism and AFib can increase with age, so the two conditions may be confused in patients over 50.
Underlying heart disorders. Coronary artery disease, heart valve disorder, and other heart muscle abnormalities can eventually lead to AFib. In these cases, treating the symptoms of AFib likely won’t be completely effective. You’ll need to get to the root of the problem – that underlying heart disorder – to treat the source if you want to alleviate the AFib symptoms.
The consequences of misdiagnosis
In the best-case scenario, having AFib diagnosed as another disorder (or vice versa) won’t cause any unnecessary suffering, and may help ward off some discomfort. But the worst-case scenario can be a life-threatening reaction to the improper treatment, which makes it incredibly important to get the right diagnosis right from the start.
Untreated AFib will result in a higher risk of stroke, and the symptoms can get worse as time goes on. And if your AFib is actually a symptom of another underlying disorder, you could be in danger of experiencing a serious medical event.
It’s always better to be safe than sorry, so put in the time to consult with your doctor, discuss your concerns and medical history, and get a second opinion if you feel like it would help. Misdiagnosis is a reality in the medical world, but those who are proactive and work closely with their doctor to sort out uncertainties will be at an advantage.
