Clinical Features

• Most affected individuals are asymptomatic.

• Less commonly, affected individuals develop symptoms of arrhythmias such as palpitations, dizziness, syncope, fatigue, and or dyspnea.

• Signs of underlying disease (e.g., murmurs of mitral stenosis)

• Tachycardia with an irregularly irregular pulse

• Apex-pulse deficit: difference between the rate of apex heart beat and that of the peripheral pulse

  • Manifests when only some cardiac contractions are strong enough to transmit a pulse wave to the periphery

  • Number of cardiac contractions (perceived with stethoscope or palpated on the chest) is higher than the peripheral pulse rate (e.g., radial artery)

• Acute left heart failure → pulmonary edema

• Thromboembolic events: stroke/TIA, renal infarct, splenic infarct , intestinal ischemia , acute limb ischemia

• Life-threatening ventricular tachycardia

Individuals with Afib may be asymptomatic for a long time before diagnosis is made.

The brain, kidney, and spleen are the three organs most likely to be damaged by emboli!