History and Physical Exam for Atrial Fibrillation
Exam Overview
Asking questions about your medical history
and doing a physical exam for
atrial fibrillation
can reveal important information
about your health and will often direct more testing. Your doctor
may ask the following questions:
- What symptoms, if any, have you
experienced?
- Have you experienced a sensation of fluttering in your
chest? Any lightheadedness? Any chest pain? Any shortness of
breath?
- Have you gained or lost more than
10 lb (4.5 kg) in the last 6
months without dieting? Do you ever feel hot or flushed?
- Have you
noticed a change in your breathing, sleeping, or eating
patterns?
- Do you exercise?
- What type of exercise do you engage
in?
- How often do you exercise?
- How do you feel during
physical activity?
- Do you tire easily while performing routine
activities?
- Have you had any recent or past illnesses, such
as
rheumatic fever
,
diabetes
, or
heart disease
?
- Do you have a family
history of atrial fibrillation, diabetes, heart disease, or thyroid
disease?
- Do you drink alcohol? If so, how much and how often do you
drink?
- Do you smoke?
- Have you ever used illegal drugs,
such as methamphetamines, cocaine, or heroin? Have you ever injected
drugs?
- What medicines, including any over-the-counter medicines, do you
take?
During the physical exam, your doctor will:
- Listen to your heart rate and rhythm through a
stethoscope, paying special attention to changes in the normal heart sounds,
such as
murmurs
or rubs, that may mean problems with blood
flow, a valve, or inflammation of the sac around the heart (
pericarditis
).
- Listen to your lungs
through a stethoscope for wheezes or other sounds of lung disease or fluid
buildup.
- Measure your blood pressure.
- Check your legs,
ankles, and abdomen for fluid buildup (edema), which can occur in
heart failure.
- Check the veins in your
neck for swelling, which is a possible sign of heart
failure.
- Assess your circulation. A dusky bluish color to the
fingers, toes, or lips or lack of hair on the feet may mean poor
circulation. Your doctor may also check for a pulse in the tops of your
feet.
- Feel your neck to check for any swelling or other changes in
your thyroid gland.
Why It Is Done
Some symptoms of atrial fibrillation, like lightheadedness, palpitations,
and chest pain, can be caused by other health problems. A medical history and physical exam will help your doctor find out what is causing your symptoms. You will need further tests, such as an electrocardiogram (EKG or ECG), to diagnose atrial fibrillation.
Results
Findings of the history and physical exam may
include the following. Normal
- Breathing, heart rhythm, and heart rate are
normal.
- Blood pressure is normal.
- No sign of fluid
buildup is present.
Abnormal Findings that may suggest atrial fibrillation or
heart failure include:
- A rapid or irregular pulse and irregular
heart sounds.
- Shortness of breath, especially during
activity.
- Fatigue, weakness, and
lightheadedness.
- Sounds in the lungs that may indicate a backup of
fluid in the lungs due to heart failure.
- Swelling in legs, ankles,
or feet or in the lower back.
- Swollen neck veins or a noticeable
change in how the blood moves through the blood vessels in the neck.
Further testing will be done if your history and physical
exam suggest atrial fibrillation.
What To Think About
It is important to provide your
doctor with detailed information about your past health and
lifestyle. Other health problems that can cause symptoms similar to atrial fibrillation include other abnormal heart rhythms, coronary artery disease, and imbalances in your blood.
Complete the
medical test information form (PDF)
(What is a
PDF
document?)
to help you prepare for this test.
Credits
ByHealthwise Staff Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology Martin J. Gabica, MD - Family Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer John M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as ofDecember 6, 2017
Current as of:
December 6, 2017
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