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Heart Palpitations or Atrial Fibrillation? How to Tell the Difference

We’ve all been there before. You may be working out, and your heart skips a beat or two or starts racing. Sometimes arrhythmia and palpitations are normal, but they can also indicate more serious issues. Here’s what you should know.

The Difference Between Palpitations & A-Fib

In most cases, it’s probably heart palpitations, which happens when it feels your heart is pounding really fast. It’s a common occurrence, especially when you’re in a tense situation. But sometimes people mistake heart palpitations for a more serious condition called atrial fibrillation, or AFib. AFib occurs when rapid electrical signals cause the heart’s two upper chambers to contract very fast and irregularly. This causes blood to accumulate in this area rather than pumping into the heart’s two lower chambers as it normally would. The condition can be very serious and lead to stroke and heart failure if left untreated.

One thing that makes AFib difficult to distinguish is that some of its symptoms could be mistaken for signs of other common conditions. In fact, heart palpitations are one of the symptoms of AFib, as is fatigue, light-headedness, shortness of breath, chest pain, decreased blood pressure and a racing heart. If you’re unsure whether your pounding heart is AFib or just palpitations, here are some ways to know the difference:

  • Context is important: If you are in a tense or anxious situation, it may be heart palpitations. In these instances, your brain releases hormones that can make your heart beat faster.
  • Pay attention to the symptoms: Palpitations caused by AFib typically last longer than those brought on by anxiety. With heart palpitations, you also may experience other symptoms like nausea and sweating.
  • Your age and health are factors: People over 65 and with pre-existing heart or thyroid conditions are more likely to have AFib.
  • Listen to your heartbeat: Your heartbeat will be very erratic with AFib, while with palpitations it’ll beat fast but in a steady pattern and slowly return to normal.

When to See a Doctor

Pay attention to when your heart beats faster. If you are in an anxiety-filled or stressful situation or exerting a lot of energy through athletics, it may not be as serious as AFib. However, if your heartbeat changes erratically without warning and you experience chest pain or difficulty breathing, don’t hesitate to see a doctor. If you have a medical history that includes arrhythmia (irregular heartbeat) or heart disease, it’s even more important to seek help immediately. Doing so could save your life or at least give you peace of mind that everything is okay. 



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