Why an AFib Diagnosis Can Be Complicated
Atrial fibrillation (AFib) is a clear and distinct disease that proceeds in a predictable manner. The problem is, the symptoms can be so quiet or vague it’s extremely difficult to trace them back to a source.
A fluttering, jumping or pounding heartbeat can point to an electrical irregularity, but many AFib patients don’t feel a thing. Having no symptoms may seem like a blessing, but it’s actually a dangerous state; if left for too long without treatment, your first sign of AFib could be a major stroke.
In other cases, symptoms may appear in uncommon patterns and tests may not pick up on the problem. As a patient, it’s good to know what AFib diagnosis will involve, how it can go wrong, and what you can do to make sure you get the right diagnosis and the best treatment.
The Typical Route to Diagnosis
The quicker the diagnosis, the better. But in cases with few symptoms it becomes more difficult to rule out other cardiac conditions. After all, the heart is a complicated and well-connected muscle, and various problems could occur simultaneously.
Diagnosing AFib starts with a description of symptoms and a series of physical tests. Your doctor will begin by listening; since a heartbeat is audible, any interruption in that beat should be, too. After listening to the heart, they may move on to:
- Check pulse and blood pressure
- Listen to your lungs
- Perform a stress (treadmill) test
- Perform an EKG
- Attach a Holter monitor or event monitor
Even with this battery of tests, AFib can hide for years behind another condition or simply sit silently. Blood tests can’t uncover AFib, but they can find other conditions that could be causing your heart problems (like infection, thyroid problems, or signs of a heart attack), and that can help to narrow down the possibilities.
What Could Lead to a Misdiagnosis?
Although clinical tests are conducted by experts in controlled conditions, they can’t catch everything. In fact, some recent studies have revealed that a startling number of AFib cases are not found with the tried-and-true methods.
Misinterpretation of Test Results
When you have an EKG, your doctor can run the results through a computer algorithm to interpret the information. In one study, 19 percent of the EKGs examined had been misinterpreted; in 24 percent of those cases, the doctor didn’t correct the mistake, so patients were given medication, management strategies, and additional testing that was unnecessary — and in some cases, harmful.
This doesn’t mean doctors are incompetent, but rather EKGs have a margin of error that should be considered. If you have any reason to question your doctor’s diagnosis, you should get a second opinion to confirm (or deny) the results.
Gaps in Medical History
Your chances of developing AFib are higher if any of your relatives have it. Unfortunately, AFib is often overlooked, ignored or unknown when it comes to relaying your family medical history to your doctor.
In cases where other medical conditions are responsible for AFib, it’s important to diagnose the root of the problem before the AFib can be cleared up.