Atrial flutter history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]

Common symptoms in patients with atrial flutter are palpitations, fluttery sensation in the chest, breathlessness and lightheadedness.

History should include duration, severity, aggravating and relieving factors for the symptoms and also about factors precipitating (alcohol, caffeine) the flutter episodes.^[1]

Patients with atrial flutter should be inquired about past history of:^[2]

• Ischemic heart disease
• Hypertension
• Hyperthyroidism
• Congenital heart disease
• COPD
• Rheumatic heart disease
• Past cardiac surgeries

Past History

Patients with atrial flutter may have a positive history of:

• Ischemic heart disease
• Hypertension
• Hyperthyroidism
• Congenital heart disease
• COPD
• Rheumatic heart disease
• Past cardiac surgeries

While atrial flutter can sometimes go unnoticed, its onset is often marked by characteristic sensations of regular palpitations. Such sensations usually last until the episode resolves, or until the heart rate is controlled.

Atrial flutter is usually well tolerated initially (fast heart beat is for most people, just a normal response to exercise), however, people with other underlying heart disease or poor exercise tolerance may rapidly develop symptoms, which can include:

• Shortness of breath
• Chest pain
• Lightheadedness or dizziness
• Nausea and, in some patients, nervousness and feelings of impending doom.

Less Common symptoms include:

• Anxiety
• Weakness
• Syncope

Prolonged fast flutter may lead to decompensation with loss of normal heart function (heart failure). This may manifest as effort intolerance (exertional breathlessness), nocturnal breathlessness, or swelling of the legs or abdomen.

Symptoms that warrant urgent medical attention include:

• Severe chest pain
• Fainting episodes

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