Global Health Asia-Pacific Dec 2021-Jan 2022 Dec 2021 - Jan 2022 - Page 118

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Patients shouldn ’ t let atrial fibrillation suppress their lifestyle

Managing the most common arrhythmia still requires healthy living
The cause of AF is unknown , but it is more common with age , in men and among those with other heart conditions such as congenital heart disease and hypertension .

The most common heart rhythm disorder , atrial fibrillation ( AF ), is characterised by irregular heart rhythm and does not discriminate between younger , athletic patients and those in their later stages of life .

While some people with AF feel heart palpitations , dizziness or tiredness , and others sense a pounding of the heart , not everyone is symptomatic , which makes it especially important for doctors to catch it when they can , said Dr Reginald Liew , a senior cardiologist at Mount Elizabeth Hospitals in Singapore .
“ Patients with AF may even not feel anything at all — they could have asymptomatic AF , and it ’ s only picked up when they see a doctor and he notices an irregular pulse ,” Dr Liew told Global Health Asia-Pacific .
“ In fact , I see quite a lot of executives who don ’ t know they have AF until they go for their annual checkup . It ’ s then the job of the doctor and the cardiologist to decide how to manage the patient .”
The cause of AF is unknown , but it is more common with age , in men and among those with other heart conditions such as congenital heart disease and hypertension .
Since AF can elevate the chance of stroke , doctors will use the CHADS2-VASc score to assess a patient ’ s risk , considering factors such as age , presence of hypertension or diabetes and history of congestive heart disease .
The type of stroke associated with AF is worse than the normal type of stroke , since blood clots can form in the left atrium when the heart is fibrillating and not emptying properly . If the clot dislodges and travels into the circulation , it can go to the brain and cause an ischaemic stroke .
At the same time , the clot may go to other parts of the body and cause emboli , or blood clots in other blood vessels such as the gut or the legs , which can also be very dangerous . All these can be reduced with proper anticoagulation medication .
Another risk of AF is that it can lead to cardiomyopathy , which is a form of heart failure .
“ Because the heart is beating fast and irregularly , it is not beating properly and becomes dilated and expands over time . Some people present for the first time with heart failure , and then they are found to have AF ,” said Dr Liew .
AF can be debilitating , even in people without heart failure or higher risk of stroke , and particularly in younger patients . Ironically , healthy , younger people — in their 30s , 40s and 50s — tend to be much more symptomatic , though it is less common for them to get AF .
Interestingly , former athletes , and especially those who have participated in endurance sports , comprise a subset of people with higher risk of AF and arrhythmias .
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