The sensation that your heart has momentarily paused, fluttered, or “skipped a beat” is a common experience known medically as a palpitation. This feeling happens when there is a brief disruption in the heart’s normal, steady rhythm. While the experience can feel unsettling, it is a frequent occurrence that most individuals encounter at some point. The heart does not literally skip a beat, but the actual mechanical event produces the distinct sensation of an irregularity.
The Medical Reality of a “Skipped Beat”
The heart does not miss a contraction, but rather experiences an extra, premature one, which throws off the timing of the normal cycle. These extra beats are called premature contractions, or ectopic beats, because they originate outside the heart’s natural pacemaker. The perception of a “skip” or a “thump” is usually the result of the heart momentarily resetting itself.
The premature contraction is often followed by a longer-than-normal pause, referred to as the compensatory pause. This pause allows the heart’s chambers to fill with more blood than usual. The next normal beat, which follows this longer pause, is then more forceful, and this stronger beat is what is typically felt as a noticeable “thump” or “jolt” in the chest.
Premature beats are categorized based on their origin. Premature Atrial Contractions (PACs) start in the atria, the two upper collecting chambers. PACs are generally considered benign and do not typically cause damage in people with healthy hearts.
Premature Ventricular Contractions (PVCs) originate in the ventricles, the two lower pumping chambers. Both PACs and PVCs are common, but PVCs are sometimes associated with a more pronounced “thump” sensation due to the longer compensatory pause that can follow them.
Common Triggers and Lifestyle Factors
In people without underlying heart disease, premature contractions are often provoked by external factors that make the heart’s electrical system more excitable. Psychological stress and anxiety are powerful triggers because they elevate adrenaline levels in the body. This surge of stress hormones increases the excitability of the heart muscle, making it more prone to generating an extra beat.
Lifestyle habits also play a significant role in causing these palpitations. High intake of stimulants, particularly caffeine, alcohol, and nicotine, can lead to premature beats. These substances directly affect the nervous system, potentially increasing the frequency of PACs and PVCs.
Several physical factors influence heart rhythm stability. Dehydration, lack of adequate sleep, and imbalances in electrolytes like potassium and magnesium are known triggers. Furthermore, certain over-the-counter medications, such as cold remedies containing decongestants like pseudoephedrine, can stimulate the heart and provoke premature contractions.
Identifying Warning Signs
While most skipped beats are harmless, certain patterns or accompanying symptoms suggest the need for a professional medical evaluation. A serious concern arises when premature beats occur at a very high frequency or in long, sustained runs. Frequent PVCs, for example, can occasionally lead to a weakening of the heart muscle over time, a condition called cardiomyopathy.
It is important to seek immediate medical attention if palpitations are accompanied by other symptoms. These warning signs include:
- Feeling dizzy or lightheaded.
- Experiencing shortness of breath.
- Having pain in the chest.
- Fainting, or syncope, which may indicate a more dangerous arrhythmia.
Individuals with a known history of heart conditions, such as heart failure or coronary artery disease, must be particularly vigilant. In these cases, even infrequent premature beats may carry a higher risk and warrant closer monitoring by a cardiologist. A healthcare provider can assess the rhythm using an electrocardiogram (EKG) or a heart monitor to determine the cause and significance of the irregular beats.