Atrial Fibrillation Patient Experiences Chest Discomfort and Heart Palpitations After Square Dancing
It is essential to understand how physical activity impacts individuals living with chronic conditions such as permanent atrial fibrillation (AFib). This case highlights the experience of a 69-year-old woman who developed chest discomfort and heart palpitations following a session of square dancing. With a medical history including hypertension, diabetes, and atrial fibrillation, she sought medical attention due to concerns about worsening symptoms. After being admitted to the hospital and receiving appropriate medication, her condition improved significantly. She was advised to monitor her heart rate and blood pressure regularly and schedule follow-up appointments.
Case Overview
This case involves a 69-year-old female diagnosed with permanent atrial fibrillation. She was treated at the First Affiliated Hospital of Xi'an Jiaotong University in December 2021. Her treatment plan included a combination of oral medications, and she stayed in the hospital for six days. Two weeks after discharge, she returned for a follow-up visit, and long-term monitoring was recommended. Her symptoms of chest discomfort and heart palpitations subsided, and her condition remained stable after treatment.
Treatment Plan
The patient was prescribed a range of medications including Rosuvastatin Calcium Tablets for lipid regulation, Propranolol Hydrochloride Tablets to manage heart oxygen consumption, Rivaroxaban Tablets for anticoagulation, Metoprolol Tartrate Tablets to control heart rate, and blood sugar management drugs such as Metformin Hydrochloride Tablets, Acarbose Tablets, and Dapagliflozin Tablets. Indapamide Sustained-Release Tablets were also included to regulate her blood pressure effectively.
Initial Consultation
During the first consultation, the patient appeared breathless and was breathing through her mouth. Her family described her history of hypertension, diabetes, and atrial fibrillation. She had been taking medication regularly but stopped two days prior due to running out of supplies. After engaging in square dancing, she experienced sudden chest discomfort and heart palpitations that did not subside. Upon examination, her heart rate was 125 beats per minute, and her blood pressure was 153/112 mmHg. Lung auscultation revealed coarse breath sounds, but no wheezing or crackles were detected. Her lower extremities showed no signs of edema. An ECG confirmed atrial fibrillation with ST-T segment changes. Based on these findings, she was diagnosed with permanent atrial fibrillation and admitted for treatment.
Course of Treatment
Considering the relatively mild nature of her symptoms, a conservative treatment approach was chosen. After discussing the plan with the patient and her family, a supportive therapy regimen was implemented to improve circulation, provide anticoagulation, and manage lipid levels. Rosuvastatin was used to lower cholesterol and stabilize arterial plaques, while Propranolol helped reduce heart oxygen demand and alleviate chest discomfort. Rivaroxaban was administered to prevent clot formation. To control her elevated heart rate, Metoprolol was prescribed alongside diabetes medications such as Metformin, Acarbose, and Dapagliflozin. Indapamide was used to maintain stable blood pressure levels.
Recovery and Results
After six days of consistent medication, the patient's chest discomfort resolved, and she no longer experienced chest pain or nausea. Upon physical examination, she was alert and in good general condition. Breath sounds remained coarse, but no abnormal lung sounds were detected. Her heart rate had decreased to 100 beats per minute with an irregular rhythm, and no pathological heart murmurs were heard. Abdominal examination revealed no tenderness or rebound pain, and there was no evidence of organ enlargement. Her lower limbs remained free of edema. Given her positive response to treatment, she was discharged with instructions to continue her medication and return for a follow-up appointment in two weeks.
Key Recommendations
It was encouraging to see the patient respond well to treatment. To support her continued recovery, the following recommendations were emphasized:
- Maintain Emotional Stability: Avoid intense emotional fluctuations that could elevate blood pressure and trigger complications.
- Monitor Health Metrics: Regularly check blood pressure and glucose levels at home and seek medical advice if abnormalities occur instead of adjusting medications independently.
- Adopt a Healthy Diet: Choose low-fat, low-sugar, and non-spicy meals to promote overall health and reduce cardiovascular strain.
- Follow Prescribed Medication Schedule: Continue taking medications as directed, even if symptoms improve, to ensure long-term stability.
Final Thoughts
This patient was an active individual who enjoyed square dancing, a popular pastime among older adults in many communities. However, her experience highlights the importance of understanding personal health limitations. Although her symptoms were manageable with prompt medical attention, it serves as a reminder that individuals with chronic conditions like AFib must be vigilant about new or worsening symptoms such as palpitations, dizziness, chest discomfort, or fatigue. Early diagnosis and treatment can significantly improve outcomes and quality of life. Encouraging proactive healthcare engagement among the elderly population is crucial for managing chronic diseases effectively.