Understanding the Sensation
Experiencing a “skipped heart beat” can be an unusual sensation, often described as a flutter, thump, or a feeling that the heart has briefly paused. These changes in heart rhythm are known as palpitations. Though concerning, heart palpitations are frequent and often not indicative of a serious underlying health issue.
When a heart feels like it skips a beat, it is experiencing a premature contraction. This means the heart’s electrical system triggers an early beat from either the atria (premature atrial contractions or PACs) or the ventricles (premature ventricular contractions or PVCs). Because this extra beat happens before the heart’s chambers have fully filled, the subsequent beat often feels stronger as the heart compensates by pumping a larger volume, creating the sensation of a “skipped” beat.
Everyday Triggers
Many factors can influence heart rhythm and lead to skipped beats. Emotional responses, such as stress, anxiety, or panic, cause the body to release hormones like adrenaline, which increase heart rate and can trigger palpitations. Managing stressors through relaxation techniques can help reduce these occurrences.
Dietary and lifestyle choices also play a role. Consuming too much caffeine from coffee, energy drinks, or sodas can stimulate the nervous system, leading to a faster or irregular heartbeat. Similarly, alcohol acts as a stimulant and can disrupt the heart’s electrical signals, causing irregular rhythms and palpitations with heavy consumption. Nicotine, found in tobacco products, and certain over-the-counter medications like decongestants, can also have stimulating effects on the heart.
Dehydration impacts the cardiovascular system. When the body lacks sufficient fluids, blood volume decreases, forcing the heart to work harder to circulate blood. This increased effort can lead to a faster heart rate and cause palpitations. Maintaining hydration helps the heart pump blood efficiently and reduces strain. Lack of sleep can also affect heart rate and contribute to palpitations, as it can disrupt the body’s normal physiological balance.
Potential Medical Causes
While many instances of skipped beats are harmless, they can sometimes signal an underlying medical condition. Thyroid disorders, particularly an overactive thyroid (hyperthyroidism), can lead to increased heart rate and palpitations. The thyroid gland produces hormones that regulate metabolism; an excess can overstimulate the heart.
Imbalances in electrolytes—minerals like potassium, sodium, and magnesium that help transmit electrical signals—can also affect heart function. When these mineral levels are too high or too low, they can interfere with the heart’s electrical stability, resulting in irregular beats. Anemia, a condition characterized by a lack of healthy red blood cells, can also cause the heart to work harder to deliver oxygen, leading to palpitations. Less commonly, structural heart conditions, such as valve problems, or other heart rhythm disorders (arrhythmias) can be responsible for persistent or concerning palpitations.
When to Seek Medical Advice
While occasional skipped beats are common and benign, certain accompanying symptoms warrant medical attention. Seek care if palpitations occur alongside chest pain or discomfort, as this could indicate a more serious heart issue. Shortness of breath, dizziness, or lightheadedness are also concerning symptoms that should prompt an evaluation.
Fainting or feeling faint during a palpitation episode is another sign for medical consultation. If skipped beats become frequent, persistent, or worsen over time, even without other symptoms, consult a healthcare provider. Individuals with a history of heart disease or a family history of heart problems should also discuss any new or changing palpitations with their doctor.
What Happens Next
When consulting a doctor about skipped heart beats, the initial assessment involves a physical examination and a review of medical history. If a more in-depth look at heart activity is needed, several diagnostic tests may be performed. An electrocardiogram (ECG or EKG) is a quick test that measures the heart’s electrical signals. For intermittently occurring palpitations, a Holter monitor (a portable ECG device worn for 24 to 48 hours) or an event recorder (worn for longer periods and activated by the user during symptoms) may be recommended to capture irregular rhythms.
Once serious medical causes have been ruled out, management focuses on lifestyle adjustments. Reducing stress through techniques like meditation, yoga, or deep breathing can help minimize palpitations. Limiting or avoiding stimulants such as caffeine, alcohol, and nicotine is advised. Staying hydrated is beneficial for heart health. Regular, moderate exercise can strengthen the heart and improve its rhythm, contributing to fewer palpitations.