Could this be AFib?

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How do you know you have AFib for sure? Is there a telltale sign?

For 8 months I've been suffering with varying symptoms. There was no catalyst a other than my father dying, though that was not unexpected or particularly traumatic in its nature.

I'm 45, male, slim, exercise regularly, all bloodwork normal.

Nobody can work out what the cause is:

- An hour after eating I sometimes feel awful fatigue, weakness, light-headedness, nausea, dizziness, tightness in chest, like I'm going to pass out

- I'm never actually sick not pass out

- When I can check my pulse it's normal (60-80)

- Tension type headaches particularly in the temporallis (above ear) and frontalis (upper temple)

- Jaw tension at times

- Nausea (sometimes without the headaches) sometimes with reflux

- Some days I have headaches, no nausea

- Some days I have nausea, no headaches

- ?Just feeling unwell

- Sometimes my vision is 1% fuzzy

- Dizziness on motion

- Light-headedness on standing

- Severe malaise, weakness

- Brain fog

- Aches behind the eyes when I have a headache

- A buzzing foggy facial feeling

Notably:

- Symptoms come on an hour after waking (30 mins after breakfast), possibly food related

- ?If I skip breakfast they wait and then can come on an hour after lunch

- ?Some days I have no symptoms but the same routine

- ?It comes on during about 30 mins, stays all day, and can disappear just as fast

- ?When it disappears I feel wonderful and very healthy, 30 mins after feeling terrible

- They sometimes remain for 4-8 hours

- They can be relieved by eating lunch (so it seems they can be caused by eating and somehow also cured by eating)

- They usually fade after sundown but not always

I've seen:

- Primary

- Neurologist

- Maxillofacial specialist

- Physiotherapist

- Chiropractor

- ?Brain scan for sinusitis

I've been misdiagnosed then ruled out:

- Chronic Sinusitis

- Migraines

- TMJ

Still under investigation:

- Tension headaches from stress

Treatments that haven't worked:

- Botox in jaw for TMJ myalgia

- Occipital nerve block

- Chiropractic treatment

Slightly helps:

- Ibuprofen

- Tylenol

- Zofran

My suspicions:

- Postprandial Hypotension

- ?Postural/orthostatic issues

- ?Hypotensive disorders (trying salt)

- ?Iron deficiency (trying supplements)

- ?Cardiomyopathy

- ?AFib

- ?Adrenal disorder

Any ideas? Thanks.

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7 Replies

  • Posted

    The short answer is you need a confirming electrocardiogram (ecg). Since the ecg only take a picture of one point in time, your doctor would want to monitor you for 24 hours or more with a halter type device that you take home. Alternatively, there are now pocket size home monitoring devices like Kardia Mobile that work with an smart phone.

    PS It doesn't sound like afib to me but we're not doctors here.

    Jim

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    • Posted

      It's a remarkable piece of technology. My electrophisiologist says its tracings are better than the event monitors they use. But like a regular ecg, they only tell the story at one point in time. So you want to use it when you feel symptomatic. Just so you know in advance, you won't have access to the first reading for up to 24 hours after doing your first ecg. By regulation, that first reading must be reviewed by one of their board cardiologists. After that, you can use it as many times as you want.

      In my case, I bought one for the opposite reason you are using it for. I had a confirmed episode of afib and want to be able to know when/if I got out of it. I was quite surprised when my first reading showed normal sinus rhythm. I was convinced I was still in afib but turned out to be PACs, a benign arrhythmia. Gave me tremendous peace of mind. I only used it a couple of times after that, again after feeling irregular beats, but again turned out to be PACs. I can now read the tracings pretty well in terms of afib. Don't plan on using it much moving forward as I think these new detection devices are a double edged sword, possibly creating more anxiety than they alleviate. I've already turned off the 24/7 heart monitor on my fitbit, and no longer wear it for sleep. I think I'll just use it for counting steps!

      Jim

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  • Posted

    Forgot to ask if you got the regular Kardia Mobile or the newer one that works with the Apple Watch? I personally think the latter is overkill and would drive me nuts, with their 24/7 "smart rhythm" monitoring/warning feature. But to each their own. The regular version is nice and small and hides nicely in the back of a drawer so you don't have to look at it unless you need it.

    Jim

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    • Posted

      I got the regular plate that syncs to your phone, so will only use it when I need to.

      Can you "feel" the heart flutter/AFib? I can sense palpitations but nothing more than that. And I've had those all my life when my heart switches gear after a stressful day.

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    • Posted

      Yes, I can sometimes feel my heart "flutter" but that doesn't necessarily mean it's afib. PACs and other benign arrhythmias can feel similar. For me, my afib espisodes are always accompanied by tachycardia (very fast rate) so that gives me a good indication. However, this isn't always the case with everyone. The Kardia will tell you soon enough if these flutters are afib or not, but my guess is they are not. BTW you can easily email the tracing to either one of Kardia's cardiologists (for a fee) or your own doctor to get a more detailed reading, for example if the irregular beats are PACs instead of Afib. 

      Jim

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  • Posted

    G'day beepatient,

    ?My short answer is, damned if I know. 

    ?The longer answer follows ...... I'm not a healthcare professional, just a patient and so my comments are a reflection of my experience.

    ?AF is pure, unadulterated mongrel. It is often all things to all people. It has no set rules and doesn't give a rats how young/old or fit you are. you can drive yourself insane looking for clues as to the hows, whys and wherefores, you can go ballistic looking for a trigger ( I was fortunate enough to find one - food), BUT do remember an AF patient can be asymptomatic ( that is you show just no identifiable symptoms at all), Yet AF can be genetic. It can also arise from a dysfunctional vagal nerve, a major nerve in the central nervous system which among other things controls both the heart and digestive system. Suggest you 'Google' some of this and have a look at schematic diagrams of the vagal (or vagus) nerve. That just touches the surface of it all, so I wish you and interesting journey.

    John

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