History and Physical Exam for Atrial Fibrillation
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.
may ask the following questions:
- What symptoms, if any, have you
- Have you experienced a sensation of fluttering in your
chest? Any lightheadedness? Any chest pain? Any shortness of
- Have you gained or lost more than
10 lb (4.5 kg) 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
- Do you exercise?
- What type of exercise do you engage
- How often do you exercise?
- How do you feel during
- Do you tire easily while performing routine
- Have you had any recent or past illnesses, such
- Do you have a family
history of atrial fibrillation, diabetes, heart disease, or thyroid
- Do you drink alcohol? If so, how much and how often do you
- Do you smoke?
- Have you ever used illegal drugs,
such as methamphetamines, cocaine, or heroin? Have you ever injected
- What medicines, including any over-the-counter medicines, do you
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,
murmurs or rubs, that may mean 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
- Measure your blood pressure.
- Check your legs,
ankles, and abdomen for fluid buildup (edema), which can occur in
- Check the veins in your
neck for swelling, which is a possible sign of heart
- Assess your circulation. A dusky bluish color to the
fingers, toes, or lips or lack of hair on the feet may mean poor
circulation. Your doctor may also check for a pulse in the tops of your
- Feel your neck to check for any swelling or other changes in
your thyroid gland.
Why It Is Done
Some symptoms of atrial fibrillation, like lightheadedness, palpitations,
and chest pain, can be caused by other health problems. A medical history and physical exam will help your doctor find out what is causing your symptoms.
You will need further tests, such as an electrocardiogram (EKG or ECG), to diagnose atrial fibrillation.
Findings of the history and physical exam may
include the following.
- Breathing, heart rhythm, and heart rate are
- Blood pressure is normal.
- No sign of fluid
buildup is present.
Findings that may suggest atrial fibrillation or
heart failure include:
- A rapid or irregular pulse and irregular
- Shortness of breath, especially during
Fatigue, weakness, and
- 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 past health and
Other health problems that can cause symptoms similar to atrial fibrillation include other abnormal heart rhythms, coronary artery disease, and imbalances in your blood.
Complete the medical test information form (PDF)(What is a PDF document?) to help you prepare for this test.
Primary Medical Reviewer
||Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer
||John M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as of
||March 12, 2014