History and physical exam for atrial fibrillation

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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 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 indicate 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 indicate 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

The history and physical exam reveal important clues about your health and help your doctor identify problems.

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 medical history and lifestyle.

Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.

Credits

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Last updated:	January 18, 2007
Author:	Robin Parks, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Laurence Epstein, MD - Cardiac Electrophysiologist
Editors:	Kathleen M. Ariss, MS, Pat Truman