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Warning-sign checks

Atrial fibrillation and atrial flutter: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for severe breathing difficulty, fainting, chest pressure, stroke symptoms, vomiting blood, coughing up blood, or heavy bleeding that will not stop.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    A serious head injury while taking an anticoagulant also warrants urgent assessment, even if symptoms initially seem mild.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up is needed even when symptoms improve.

    The rhythm can return without being felt, and stroke-prevention decisions are not based only on whether a person currently notices an irregular heartbeat.

    At routine visits, the care team may review:

    • Heart rate, rhythm, blood pressure, and symptoms
    • Stroke and bleeding risks
    • Anticoagulant use, adherence, interactions, and side effects
    • Kidney or liver tests when relevant to medicine safety
    • The effectiveness and side effects of rate- or rhythm-control treatment
    • Blood pressure, weight, sleep apnea, alcohol use, and other modifiable risks

The article also says

After cardioversion or ablation, follow the specific plan for medicines and rhythm monitoring.

Do not stop anticoagulation or other heart medicines solely because a home monitor reports a normal rhythm.

Seek timely medical advice for increasing palpitations, worsening exercise tolerance, new swelling, repeated dizziness, or possible medicine side effects.

Unusual bleeding while taking an anticoagulant also needs medical review.

Every sign above is quoted from the sofidex article on Atrial fibrillation and atrial flutter. If you are not sure, err upward — it is always reasonable to be checked.