Atrial fibrillation in young adults

Age influences some treatment decisions, but it does not make an irregular rhythm safe to ignore. An electrocardiogram is needed to identify the rhythm because palpitations can have several causes.

A clinician may look for thyroid problems, high blood pressure, heart structure changes, sleep apnoea, acute illness and family or inherited heart conditions. Episodes may also be associated with heavy alcohol intake, stimulant or recreational drug use, dehydration, poor sleep or intense exertion.

Some people notice a racing or fluttering heartbeat, breathlessness, tiredness, chest discomfort or dizziness; others have few symptoms. Atrial fibrillation commonly presents with palpitations, but palpitations alone do not establish the diagnosis.

Note when episodes start and stop, your pulse or wearable recording if available, associated symptoms, recent illness, sleep, exercise, alcohol, caffeine, supplements and other substances. Do not rely on a wearable alert as a final diagnosis; share the tracing with a clinician.

Testing may include an electrocardiogram, longer rhythm monitoring, blood tests and heart imaging, depending on the history. Management can involve treating a trigger, controlling heart rate, restoring rhythm or considering anticoagulation after an individual clot and bleeding assessment.

Use emergency services for severe chest pain, marked breathing difficulty, collapse, or sudden weakness, facial droop, speech trouble, confusion or vision loss. A brief neurological symptom still needs emergency assessment because a transient ischaemic attack can precede a stroke.

Seek prompt clinical advice for a new persistent irregular heartbeat or repeated episodes with dizziness, breathlessness or reduced ability to exercise. If you already have a plan for recurrences, follow its instructions and report any change in the pattern.

Ask whether the rhythm has been documented, which reversible causes are being checked, whether activity needs temporary adjustment, and what to do during another episode. Discuss family heart history and whether relatives have experienced rhythm problems or unexplained sudden death.