The Rhythm is Gonna Get You

Under normal circumstances, I love salsa. It’s delicious with anything. Chips. Eggs. Fajitas. There is only one context that I don’t. Dancing. I don’t know how my wife was able to convince me, but I agreed to going to a dance class with her. One of the things that I pride myself on is that I can do an average to an above average job with most tasks, whether it’s fixing a ceiling fan or writing on a blog or competing in a food competition. Dancing was a challenge.

We went to the class and I was expecting to do the usual. How hard can following some steps be? The class was taught by some young, professional dancer with years of experience that made it look so effortless. There were plenty of people in the class, thankfully, so I was able to hide among the crowd. Move a foot here, then there, and then go back. Put your hand here and here. Watch your posture. Watch your feet. Watch your partner. Don’t forget the hips. Move the hips. And once I had all the steps memorized, don’t forget about the rhythm. After kicking my wife by accident, spinning on a “cumbia” step and smacking another couple, I got lost in my footing and decided that I needed a break.

Dancing should be effortless. I shouldn’t have to consciously think of where my foot belongs when my hip is here or there. It should be second nature to do it right, otherwise, it’s just a hot mess on a dance floor. The same can be said about the heart. The heart has a very specific rhythm that starts in the right atrium, and is carried throughout the chambers. It’s a very coordinated movement, as it should be, considering it does this about sixty to ninety times a minute. One misstep, and the whole routine gets thrown off. Fortunately for the heart, there are failsafes in place in case the electrical impulse misfires, but even still, sometimes those fail.

When patients develop a condition known as atrial fibrillation (a-fib), the atria, or the top chamber of the heart, misfires causing the heart to quiver instead of beating fully. As a result, the heart “loses its footing” and is stuck in a discoordinated rhythm. When this happens, the blood remains in the chambers of the heart instead of moving onto the lungs, brain, and elsewhere. When blood sits for too long of a time, it can possibly lead to a clot, which can ultimately be fatal.

Some patients can experience this heart arrhythmia by developing fatigue, palpitations, shortness of breath, anxiety, sweating, dizziness, or chest pain or pressure. Some patients may not have any symptoms at all. When the heart rate starts to exceed 100, the risk of secondary complications like stroke and heart attack go up, which is why rate control with medications is one of the possible treatment plans when this occurs.

With paroxysmal a-fib, there is a return to the normal rhythm within a week’s time. This can be a spontaneous return, where the heart catches up with its footing, or it can be with assistance of medications or electrical shock. When the heart is unable to get back to normal, it becomes a chronic problem. Because of the risk of stroke, which chronic a-fib patients have a five fold increased risk of, blood thinners may be a part of the treatment. Physicians have a specific way of calculating the risk, and not all patients may be placed on this.

There are a lot of things that can potentially trigger a-fib, like stimulant use (ie. caffeine, tobacco, drugs), lung disease, thyroid disease, heart disease including valvular disease, and even high enough blood pressure. Some of the things a patient can do to reduce this risk is to modify certain lifestyle choices. Don’t smoke. Exercise regularly. Limit caffeine and alcohol use. Avoid recreational drug use. Drink ample amounts of water. Limit stress. Avoid binge drinking alcohol as this is textbook reason for a-fib known as holiday heart. Moderation is key in maintaining general heart health.

After some sore shins and a bruised ego, I finally got the rhythm. My wife gave me a reassuring nod, finally achieving a breakthrough. The class ended with me giving a giant sigh of relief. I’d like to think that I’m average with the salsa, but the truth is that I suck at it. My wife still urges us to go dancing every now and then, and I just laugh it off, complaining of exhaustion. Rhythm is everything when it comes to dancing and I’m smart enough to know that either you’ve got it or you don’t.

By: Dr. Juan Borja
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