Atrial fibrillation (Afib) is a common heart rhythm disorder where the heart’s upper chambers beat irregularly and often rapidly, causing them to quiver instead of contracting effectively. This chaotic electrical activity disrupts the normal flow of blood and increases the risk of serious complications, such as stroke or heart failure. Understanding the difference between an expected Afib episode and a life-threatening event is crucial for anyone living with this condition. This article will help you understand when to seek immediate emergency care and when it is safe to contact your established healthcare team first.
Immediate Emergency Warning Signs
Certain symptoms accompanying an Afib episode indicate the heart is failing to pump blood effectively, requiring calling 911 or seeking immediate emergency care. Severe chest pain or pressure is a primary concern, especially if it feels heavy, crushing, or radiates to the arm, jaw, or neck, as this could signal a heart attack.
Any symptom suggesting a sudden lack of blood flow to the brain is an immediate emergency. This includes syncope (sudden loss of consciousness) or feeling severely lightheaded or dizzy. Severe and sudden shortness of breath that worsens rapidly may indicate acute heart failure, where fluid backs up into the lungs. Signs of a stroke are also an absolute emergency, including sudden weakness or numbness on one side of the face or body, slurred speech, or acute confusion. Immediate transport to the emergency room is necessary to prevent permanent damage.
When to Contact Your Cardiologist First
Not every Afib episode requires an emergency room visit, especially for individuals with an established treatment plan. If you experience a new onset of Afib symptoms, such as palpitations or a racing heart, but feel stable without severe emergency signs, contact your cardiologist’s office first. The medical team can often guide you on managing the episode at home or direct you to an urgent care facility, avoiding an unnecessary trip to the emergency room.
A sustained rapid heart rate, consistently above 120 to 130 beats per minute for several hours without causing severe distress, warrants a call to your doctor. If you are not experiencing chest pain or fainting, your cardiologist can provide guidance on adjusting rate-controlling medication or scheduling an urgent assessment. If palpitations or fatigue are more frequent or severe than your usual baseline, but still tolerable, report this change to your care team. An Afib episode lasting longer than 24 to 48 hours without reverting to a normal rhythm should also prompt a call, as they may recommend elective cardioversion or medication adjustment.
Preparing for Emergency Care
Taking proactive steps can significantly streamline your care should an emergency arise. A small “Go Bag” containing important medical information should be kept readily accessible. This bag should include:
- An up-to-date list of all current medications, including dosages and frequency, especially blood thinners or rhythm control drugs.
- A list of known drug allergies.
- Your cardiologist’s contact information.
- A brief, written timeline of your symptoms, noting exactly when they started and what they felt like.
Emergency medical staff will also need to know about any recent changes in diet, alcohol consumption, or new over-the-counter medications, as these can sometimes trigger Afib. Having this information organized helps staff make rapid and informed decisions regarding your treatment.