Clinical Presentation

While patients can be asymptomatic, many experience a wide variety of symptoms as a consequence of the hemodynamic dysfunction.  The lost of the synchronous atrial activity, the irregular ventricular response, the rapid heart rate, and the impaired coronary blood flow all contribute to the mechanism.  Palpitations, fatigue, and dizziness can be quiet common, while symptoms related to congestive heart failure including dyspnea and angina can develop in more severe cases.  Finally, a few will experience thromboembolic phenomenon as a consequence of blood flow stasis within the atrium, endothelial dysfunction, and hypercoagulability (Virchow’s triad).  The dislodgement of a clot from the atrium resulting in an embolus to the brain (transient ischemic attach or stroke) or to the mesenteric circulation (bowel ischemia) can have severe consequences and require immediate attention.

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