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Other risk factors for atrial fibrillation include diabetes, coronary heart disease, mitral valve disease, atrial septal defect, alcohol excess, and hyperthyroidism. SIGNS AND SYMPTOMS Patients diagnosed with atrial fibrillation may present with signs and symptoms rang-ing from being completely asympto-matic to dangerously hemodynamically unstable. Signs and symptoms associated with atrial fibrillation include palpitations, anxiety, fatigue, malaise, exercise intolerance, and nausea. Dyspnea, dizziness, syncope, hypotension, chest pain, diaphoresis, and, in some cases, confusion and altered mental status are common.