Can Atrial Fibrillation Give Me a Heart Attack?

In this video I discuss if AFib can cause a heart attack and the known risk factors for atrial fibrillation and coronary artery disease.

Many patients, when they have episodes of atrial fibrillation, they can feel chest pain and feel as if they are having a heart attack. So, can atrial fibrillation actually give you a heart attack?

The answer to that question is both yes and no. In this article I will explain why I answer it that way.

Atrial fibrillation by itself is unlikely to cause a heart attack in somebody who has an otherwise normal heart, meaning you've never had a heart attack before, that you don't have any blockages, or you've never had coronary bypass surgery, and your heart is otherwise normal. It would be very unlikely to see AFib cause a heart attack, even if your heart was going pretty fast, 120, 150 beats per minute, maybe even faster. Again, if your heart were otherwise normal, such as with a normal pumping strength and no blockages, it would be unlikely for it to cause a heart attack.

However, patients who have atrial fibrillation typically have very common risk factors for also developing coronary artery disease, such as high blood pressure or diabetes, or they're usually older in age. These risk factors are all common risk factors for developing coronary artery disease.

So, when people have underlying coronary artery disease and you get an episode of atrial fibrillation and your heart rate is going fast, it can certainly put a strain on your heart and can cause signs of a heart attack including chest pain.

When somebody is first admitted to the hospital with atrial fibrillation, many blood tests are done, but a blood test that is commonly done is what's called cardiac enzymes. These are blood tests looking for proteins called troponins that are released when there are signs of heart damage. It's not uncommon that these blood tests are abnormal when people have episodes of atrial fibrillation and also underlying coronary artery disease, and that indicate signs of a heart attack.

Fortunately, these heart attacks from atrial fibrillation are typically not massive or large heart attacks.

The blood test might just be a little bit abnormal, but the blood test being even a little abnormal is just a marker that there is likely underlying coronary artery disease. I've talked many times that the risk factors for atrial fibrillation, the common risk factors, such as age, high blood pressure, diabetes, and smoking, these are all risk factors for also having coronary artery disease, so the risk factors are very similar.

As a result, it's always important, if you've been diagnosed with atrial fibrillation, to undergo screening for coronary artery disease, such as with like a stress test, to make sure there are no signs of any significant coronary artery disease, because the two risk factors are very similar.

Learn More About the Management of Atrial Fibrillation in Patients with Existing Coronary Artery Disease.

In this series I discuss common signs and symptoms of atrial fibrillation including palpitations, heart racing, chest pain, and shortness of breath.

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