Beyond the Heart Attack: The Rise of Atrial Fibrillation in Non-Traditional Cardiac Patients
When it Comes to Heart Health, We Vastly Underestimate Who’s at Risk
By Monica Vanover on February 12, 2025
When we think of heart disease, the image that often comes to mind is an older man clutching his chest during a heart attack. However, according to Dr. David Burkland, a cardiac electrophysiologist for HCA Houston Healthcare Medical Center, this stereotype overlooks a significant portion of cardiac patients who don't fit the traditional mold.
"Heart disease is still the leading cause of death in the US," explains Dr. Burkland. "While it's slightly more prevalent in men, it's also the leading cause of death in women." The key difference? Women often present with non-traditional symptoms, leading to delayed diagnosis and treatment.
This misconception reflects a larger truth: when it comes to heart health, we vastly underestimate who’s at risk. Heart events are occurring in younger patients. And it’s not simply heart attack or stroke. Irregular heartbeat, medically known as atrial fibrillation (AFib), is a growing concern.
AFib is a heart rhythm disorder where the top chambers of the heart (atria) beat extremely rapidly - around 400-500 beats per minute. As Dr. Burkland explains, this causes the atria to essentially "writhe" or "wiggle" rather than contract properly. Since the chambers aren't pumping effectively, blood can pool and potentially form clots, increasing stroke risk. The condition is progressive, typically starting with occasional episodes (paroxysmal AFib) and potentially developing into persistent AFib where the heart stays in this irregular rhythm. Persistent AFib can lead to serious cardiac events, including stroke and even death.
The good news: there’s plenty you can do about your heart health. From preventative lifestyle hacks to state-of-the-art interventions by the cardiac specialists at HCA Houston Healthcare, getting a hold on your heart health is possible. In recognition of American Heart Month, here’s everything you need to know about heart health.
"Heart disease is still the leading cause of death in the US. While it's slightly more prevalent in men, it's also the leading cause of death in women."
Dr. David Burkland, cardiac electrophysiologist
The Silent Threat: Early Detection is Key
Perhaps most surprising is that you can be physically fit and still develop heart problems. "We only have so much control over our heart health," Dr. Burkland notes. "One of the most important risk factors is non-modifiable: the genetic cards you're dealt." This means that even individuals who maintain healthy diets and exercise regularly can develop cardiac issues due to their family history.
One often-overlooked cardiac condition is atrial fibrillation (AFib), the most common heart rhythm disorder worldwide. Contrary to popular belief, only about one-third of AFib patients can actually feel their irregular heartbeat. The majority experience more subtle symptoms like gradual fatigue, decreased exercise tolerance, or shortness of breath – symptoms that are easy to dismiss or attribute to aging or stress.
Regular visits to your primary care physician are crucial for catching cardiac issues before they become serious. Many risk factors, including high blood pressure and cholesterol, are "completely silent and asymptomatic," according to Dr. Burkland. Without routine screening, these issues can go undetected until they cause significant problems.
In the case of AFib, early detection is particularly critical. "Twenty-five percent of people's earliest presentation of AFib is a stroke," Dr. Burkland warns. These strokes tend to be more severe than those from other causes, potentially affecting entire sides of the body.
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AFib Treatment Options
Modern cardiac care offers various treatment options, particularly for rhythm disorders like AFib. Treatment typically involves three components:
1. Blood thinners to prevent stroke
2. Rate control medications to prevent the heart from beating too fast
3. Rhythm control through either medication or procedures
Recent advances in treatment include ablation procedures, where doctors can use heat, freezing, or electrical currents to create strategic scar tissue that prevents irregular rhythms. These minimally invasive procedures have shown promising results in managing AFib.
25% of people's earliest presentation of AFib is a stroke that is more severe than those from other causes, potentially affecting entire sides of the body.
While genetics play a significant role, there are several ways to modify your cardiac risk:
Interestingly, Dr. Burkland notes that both extremely sedentary lifestyles and intense endurance athletics can increase AFib risk. The sweet spot lies in moderate, regular exercise.
The Future of the Non-Traditional Heart Patient
Heart disease is becoming more prevalent and appearing earlier in life, partly due to rising obesity rates. However, awareness of non-traditional symptoms and risk factors, combined with regular medical screening and lifestyle modifications, can help identify and address cardiac issues before they become severe.
The key takeaway? Don't wait for chest pain to think about your heart health. Regular check-ups, attention to subtle symptoms, and a heart-healthy lifestyle are essential for everyone, regardless of age, fitness level, or family history. Make an appointment now to see your HCA Houston Healthcare physician. Learn more about your health at HCAhoustonhealthcare.com/heart.
sponsored by: HCA HOUSTON HEALTHCARE
What You Can Do to Control Your Risk
Maintain a healthy diet low in carbohydrates and red meat, high in fish, poultry, and fresh produce
Consider intermittent fasting, which some studies suggest can reverse metabolic syndrome
Exercise moderately 4-5 times weekly for at least 25 minutes
Monitor your heart rhythm using wearable devices like smart watches
Keep regular appointments with your primary care physician
Know your numbers: blood pressure, cholesterol, and body mass index
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When we think of heart disease, the image that often comes to mind is an older man clutching his chest during a heart attack. However, according to Dr. David Burkland, a cardiac electrophysiologist for HCA Houston Healthcare Medical Center, this stereotype overlooks a significant portion of cardiac patients who don't fit the traditional mold.
"Heart disease is still the leading cause of death in the US," explains Dr. Burkland. "While it's slightly more prevalent in men, it's also the leading cause of death in women." The key difference? Women often present with non-traditional symptoms, leading to delayed diagnosis and treatment.
This misconception reflects a larger truth: when it comes to heart health, we vastly underestimate who’s at risk. Heart events are occurring in younger patients. And it’s not simply heart attack or stroke. Irregular heartbeat, medically known as atrial fibrillation (AFib), is a growing concern.
AFib is a heart rhythm disorder where the top chambers of the heart (atria) beat extremely rapidly - around 400-500 beats per minute. As Dr. Burkland explains, this causes the atria to essentially "writhe" or "wiggle" rather than contract properly. Since the chambers aren't pumping effectively, blood can pool and potentially form clots, increasing stroke risk. The condition is progressive, typically starting with occasional episodes (paroxysmal AFib) and potentially developing into persistent AFib where the heart stays in this irregular rhythm. Persistent AFib can lead to serious cardiac events, including stroke and even death.
The good news: there’s plenty you can do about your heart health. From preventative lifestyle hacks to state-of-the-art interventions by the cardiac specialists at HCA Houston Healthcare, getting a hold on your heart health is possible. In recognition of American Heart Month, here’s everything you need to know about heart health.