A “skipped heartbeat,” often described as a palpitation, is a common sensation many individuals experience. It can manifest as a fluttering, a thumping, a racing feeling, or even a brief pause in the heart’s rhythm. While often harmless, this unusual sensation can understandably prompt concern. These feelings can occur at any time, whether at rest or during activity.
What Skipped Heartbeats Feel Like
The sensation of a “skipped heartbeat” is typically not the heart literally missing a beat. Instead, it frequently results from a premature beat, known as a premature ventricular contraction (PVC) or a premature atrial contraction (PAC). A PVC originates in the heart’s lower pumping chambers (ventricles), while a PAC starts in the upper chambers (atria). This premature electrical impulse causes the heart to contract earlier than expected.
Following this early contraction, there is often a compensatory pause as the heart’s natural pacemaker resets. The next normal beat occurs after this pause, and because the heart has had more time to fill with blood, the subsequent contraction is often stronger. This more forceful beat, combined with the preceding pause, creates the distinct feeling of a “thump,” a “pound,” or the perception that the heart “skipped” a beat.
Common Non-Concerning Causes
Many instances of skipped heartbeats are benign and arise from everyday factors. Stress and anxiety are frequent triggers, as they activate the body’s “fight or flight” response, increasing heart rate and potentially leading to palpitations. Emotional responses can cause a release of adrenaline, which directly influences heart rhythm.
Certain substances can also contribute to these sensations. Caffeine, nicotine, and alcohol are common stimulants that can disrupt the heart’s regular rhythm. Over-the-counter stimulant medications, such as decongestants, can similarly affect heart activity. Dehydration and imbalances in electrolytes, like potassium or magnesium, can interfere with the electrical signals that regulate heartbeats.
Hormonal changes, particularly those experienced during menstruation, pregnancy, or menopause, can lead to palpitations. Fluctuations in estrogen levels, for instance, can affect the cardiovascular system and heart’s electrical activity. Other factors like lack of sleep, intense exercise, and even digestive issues such as indigestion or bloating can also occasionally cause these sensations.
Signs Indicating Concern
While many skipped heartbeats are harmless, certain accompanying symptoms signal a need for prompt medical attention. Experiencing skipped beats along with chest pain or pressure is a significant warning sign. This combination could indicate a more serious underlying cardiac issue.
Severe shortness of breath occurring with palpitations also warrants immediate evaluation. Dizziness, lightheadedness, or fainting (syncope) in conjunction with skipped heartbeats are concerning symptoms. These suggest that the heart may not be effectively pumping blood to the brain.
Palpitations that occur frequently, persist for extended periods, or worsen over time should also be medically assessed. Individuals with known heart conditions, such as existing heart disease, structural heart changes, or a history of heart attack, should be particularly vigilant. Any skipped beats that feel distinctly different or more severe than previous episodes also warrant medical consultation.
Medical Evaluation and Conditions
When skipped heartbeats cause concern, healthcare professionals employ various methods to diagnose the underlying cause. The diagnostic process typically begins with a thorough medical history, where the doctor inquires about the nature and timing of symptoms, as well as any relevant personal or family health history. A physical exam is also conducted, including listening to the heart and lungs.
An electrocardiogram (ECG or EKG) is a common initial test, which measures the heart’s electrical activity and can detect irregular rhythms. For palpitations that occur infrequently, a Holter monitor or an event recorder may be used; these portable devices record heart activity over 24 hours or longer periods during daily life. An echocardiogram, an ultrasound of the heart, can assess its structure and function, identifying issues like valve problems or cardiomyopathy. Blood tests are also performed to check for factors such as thyroid disorders, anemia, or electrolyte imbalances.
Underlying medical conditions that can cause skipped heartbeats include various arrhythmias, which are irregular heart rhythms. Examples include Atrial Fibrillation (AFib), where the heart’s upper chambers quiver instead of beating effectively, and Supraventricular Tachycardia (SVT), a fast heart rhythm originating above the ventricles. More serious rhythms like Ventricular Tachycardia (VT), a rapid rhythm from the lower chambers, can also cause palpitations. Structural heart diseases, such as heart valve problems or cardiomyopathy, can also manifest with palpitations. Additionally, conditions like an overactive thyroid (hyperthyroidism) or anemia can lead to these sensations.