After almost dying during emergency heart surgery, Mellanie True Hills left a successful corporate life to spread the word about women and heart disease by launching the non-profit American Foundation for Women’s Health and publishing A Woman’s Guide to Saving Her Own Life.

On StopAFib.org, she blogs, “Seven months after my initial heart problem, my heart skipped a beat, I became dizzy, my right leg grew cold, and the vision in my right eye grew fuzzy—I had blood clots and a close call with stroke due to atrial fibrillation.”

Mellanie experienced an irregular heartbeat, or atrial fibrillation (AF), which is a precursor to stroke that most people have never heard of, according to the American Heart Association. Fear shaped her ongoing condition as she learned more about AF.

“I never knew when an episode would strike—I might be washing the dog or out walking or even on a conference call, and was always afraid. My episodes would start with a skipped heart beat, followed by strong heart palpitations. My heart would race and pound, and then the dizziness would overwhelm me. I would become light-headed and be afraid of passing out,” she writes.

Mellanie now encourages women to consider if they’ve ever been told they have an irregular heartbeat. After all, some people get heart palpitations when they take in too much caffeine and many others may be aware of an occasional flip flop, which most often is harmless.

But those with symptoms like Mellanie’s are serious. AF can put you at risk for stroke, the third leading cause of death in the U.S. In the past two decades, hospital admissions for AF have more than doubled, admissions are expected to continue climbing because of our aging population, the increasing prevalence of heart disease (including in younger women as obesity and diabetes rates continue to increase) and new techniques that help healthcare providers more accurately diagnose AF.

If diagnosed and treated, AF doesn’t always have dire consequences but it definitely requires medical attention. The most common symptoms range from heart palpitations and fainting to chest pain that can be confused with heart attack.

During AF, your heart’s two upper chambers (the atria) quiver chaotically in what experts call fibrillation. Only random impulses from the top chambers reach the lower pumping chambers of the heart and with the upper chamber out of synch with your heart’s lower chamber, you can experience a fast and irregular heartbeat as high as 180 beats per minute.

When this happens, experts say, you can have a whole cascade of symptoms, from a racing heart and weakness and shortness of breath to a rapid drop in blood pressure that can cause fainting. Stagnating blood in the inefficiently quivering atria can form clots. If a blood clot forms and gets pumped out, it can get lodged in an artery in your brain, causing a stroke.

In fact, if you have AF, your risk for stroke is up to 7 times that of a person without AF. Drugs are available both to thin the blood for preventing clots and to slow or, ideally, revert an irregular heart rhythm to normal. But could you recognize the early signs of AF and seek treatment to prevent it?

As many as one-third of people with AF have no underlying health conditions that would raise their risk. This type of AF, called lone AF, often runs in families. The way we live can also set us up for AF: holiday heart syndrome is what some experts call the AF that results from binge drinking. Caffeine, tobacco, an overactive thyroid gland and heart disease can also trigger AF.

Talk to your healthcare provider about AF and your stroke risk if you notice your heart beating too fast, slowly or irregularly or awakening you from sleep. Do you tire easily during exercise? Do you experience chest pain or shortness of breath? Do you ever feel light-headed or confused? If you experience swelling in your legs on a regular basis, or awaken in the middle of the night with breathlessness, these too may be warning signs.

Sadly, AF is sometimes diagnosed only after a stroke or mini-stroke, what experts call a transient ischemic attack. How you live greatly affects whether you may ever be diagnosed with AF. Keeping your heart healthy is the best way to prevent AF.

Protect your heart health: manage your cholesterol and blood pressure, maintain a healthy weight and eat well and exercise, which will also prevent diabetes. Avoid excess alcohol intake and avoid tobacco products completely. Ask your healthcare provider about the decongestants in cough and cold remedies (even nasal sprays) that may increase risk of an episode of AF.

AF can be treated. Normal heart rhythm can be restored by low-energy electrical countershock, done under sedation or light anesthesia. Drug therapy is targeted at restoring and maintaining a normal rhythm for your heart or controlling a fast heart rate. Blood-thinning drugs, called anticoagulants, can also be prescribed—these require careful and ongoing follow-up with your healthcare provider to maintain the right dose.

Sometimes AF is the first sign of underlying heart disease. If AF is suspected, an exam may reveal a structural or valve abnormality, or hardening of the arteries (atherosclerosis) as the underlying cause of AF. Surgery may be needed wherein a small catheter is threaded through a vein into the heart to identify the faulty electrical tissue and destroy a small area with radiofrequency energy. Specially trained cardiologists, called electrophysiologists, do these procedures, which have a high success rate.

Reduce high blood pressure. If your blood pressure is 140/90 mmHg or higher, you’re at the highest risk for AF.
Lose weight if you’re overweight or obese. If your body mass index (BMI) is 25 or more, you’re at risk and you should know that losing just 10% of your current weight dramatically improves your health and your heart disease risks.
Get active. You need to be active for at least 30 minutes a day for 5 days a week—and 7 is better. Work up to 60 minutes a day and then add 2 days of strength training with at least 2 days of rest in between sessions for optimal benefit.
Eat a low-fat diet. Keep saturated and trans fats to less than 7% of your diet and up your intake of omega-3 fatty acids, which also help with high cholesterol.
Drink in moderation only and don’t smoke or use tobacco.
Prevent or manage diabetes. Maintaining a healthy blood sugar level on a daily basis is critical; if you have diabetes, ask your healthcare provider for an A1C test, which will reveal your average blood-sugar level over a 3-month period. This is a more accurate picture of your blood sugar levels than any one daily reading.


Do you have any of the following risk factors?

• Heart attack or heart failure
• Coronary artery disease
• Heart valve disease
• Previous heart surgery
• Congenital heart disease
• Obesity
• Stroke
• High blood pressure (hypertension)
• Sleep apnea
• Diabetes
• Chronic lung diseases (emphysema or chronic obstructive pulmonary disease)
• History of rheumatic fever
• History of substance abuse, including more than 3 drinks a day or smoking

About the Author: Suzanne Hughes, MSN, RN, is the director of patient and community education and research at Robinson Memorial Hospital in Ravenna, OH, and associate editor of Cardiosource, the online journal of the American College of Cardiology.