Causes of Skipped Heart Beats
Healthy Heart Beat
A healthy adult heart beats regularly at the rate of 60 to 100 times per minute. This process is governed by the speed of electrical signals originating from the SA (Sinoatrial) node.
How Does the Heart Beat
The human heart is made up of four chambers. Two upper chambers are called atria. Two lower chambers are called ventricles. The electrical signals travel from the sinoatrial node to the upper heart chambers (atria). They facilitate contraction of these chambers, enabling them to deliver blood to the lower heart chambers (ventricles).
The electrical signals then reach the ventricles through the AV (atrioventricular) node. They facilitate contraction of ventricles, thereby pumping blood to the rest of the body. This regular flow of electricity from SA node to AV node resulting in contraction of the heart muscle is known as a "sinus" beat.
Have you ever stopped and listened to your heartbeat?
Healthy Heart Beats Regularly at the Rate of 60 to 100 Times per Minute
Skipped Heart Beats
Sometimes the heart may not beat at a regular rate. It may "Skip a beat" (ectopic heartbeat). This happens when the heart's regular rhythm is interrupted by early or premature beats.
Heart Skipping a Beat
Romantic movies and songs are replete with references to the heart skipping a beat when one is in love. It is common to experience a fluttering in your heart when the object of your love enters the vicinity, whether it is a person or a thing.
Heart Skipping a Beat Frequently Can Be Harmful
Biologically speaking the skipping of a heart beat is not a good sign, because it indicates that all is not well in the heart. Atrial fibrillation, the medical term for irregular heartbeats, has been associated with elevated risk of stroke, and research studies have suggested that irregular heart beat may enhance the risk of developing many diseases.
Heart Doing Flip-Flops
‘It feels like my heart is doing flip-flops, turning over in my chest,” a middle-aged real estate broker told Marvin M. Lipman, Consumer Reports’ chief medical adviser.
The lady was describing the heart palpitations she had been experiencing for several days. A fast or slow heart rate, extra or skipped heartbeats, or forceful, irregular or pounding heartbeats are all palpitations. Even if you consider them trivial, they should be brought to the attention of your physician.
Lipman’s patient did not require need an extensive investigation. The description of her palpitations was on target, and a few PACs showed up on an office electrocardiogram.
Pseudoephedrine Was the Culprit in This Case
Treatment consisted of advising her to stop taking the pseudoephedrine she was using as a decongestant for a cold. She called a few days later to say she was no longer having heart flip-flops.
It feels like my heart is doing flip-flops, turning over in my chest.— A middle-aged real estate broker
Possible Causes of Skipped Heart Beats
There are many causes for skipped heart beats. Skipped beats may be caused by PAC (Premature Atrial Contractions) or PVC (Premature Ventricular Contractions).
Skipped Heart Beats May Be Caused by PAC or PVC
Coffee does more than just keeping you alert—it gives your heart a jolt too. Just like alcohol, excessive intake of caffeine can affect the way your heart beats. This is especially true for energy drinks and shots that contain high levels of caffeine in smaller doses.
Even excessive consumption of coffee and black or green teas can increase your heart rate and make it feel as though your heart has skipped a beat if you are sensitive to caffeine. Caffeine stimulates stress hormones to rapidly pump through your body, which exacerbates abnormal heart rhythms, like skipped beats.
“It’s not that caffeine is causing it to skip, it is just making it more obvious, more prevalent, and making it show up and cause symptoms,” says Dr. Hussein. Try cutting back on your intake by consuming decaf after your first to see if that helps regulate your heartbeat. Or try switching to tea and see if that makes a difference.
It’s not that caffeine is causing it to skip, it is just making it more obvious, more prevalent, and making it show up and cause symptoms.— Ayman Hussein, MD, a cardiac electrophysiology specialist at the Cleveland Clinic in Ohio
Stress is unhealthy, especially when it comes to the heart. When you are stressed, your brain activates its fight-or-flight response due a surge of adrenaline; this helps your body react quickly to the stressor.
In response to this sudden increase in stress hormones your heart may skip a beat because it is working harder to increase blood supply to your muscles, heart, and other organs.
A sudden devastating event, like the loss of a loved one, can trigger broken heart syndrome, a condition in which the affected person may feel as though they are having a heart attack and their heart is skipping beats.
Even getting spooked by a friend can get that adrenaline coursing through your veins, which may make you feel a sudden pause in your chest. “Stress isn’t creating the problem, it’s making the problem more prominent,” says Dr. Hussein. “Stress hormones are known to correlate with these types of extra beats.” Stress not only hurts your heart, but also throws your immune and digestive system off.
Are you taking steps to manage stress?
Alcohol sends your heart’s electrical rhythm on the fritz. It also raises the adrenaline in your blood. The rise in these stress hormones increases the free fatty acids in your blood, which are known to contribute to irregular heart beats, and adrenaline in your blood, which may cause a premature beat.
Typically, these symptoms only last for a few seconds or disappear within one day as the alcohol leaves your body. But you should seek a doctor, if these premature beats are frequent.
Alcohol can lower your blood pressure, which means your heart needs to work harder to ensure that the blood circulating in your body gets to where it needs to go.
Binge drinking, which is unfortunately and alarmingly common among teens, can cause your heart’s rhythm to falter and result in a skipped beat, as can a small amount for someone who drinks regularly.
Excessive amounts of alcohol can precipitate atrial fibrillation, an irregular heart beat disorder that can lead to stroke, heart failure, or a heart attack, if left untreated. Moderation is key, so limit yourself to only a few glasses each week instead of slugging back three glasses a day. It is wise to give up.
Lack of Sleep
A sleepless night leaves both you and your heart feeling tired and miserable the next day. “When you don’t get good quality of sleep you feel irritated,” says Dr. Hussein. “The body tries to react to lack of sleep by increasing certain hormones to deal with the stress. The stress hormones can trigger those extra beats.”
To solve this, make sure you get the recommended seven to eight hours of sleep every night. Sahaj Marg way of life helps you get good quality sleep in the night.
Low levels of essential minerals like potassium and magnesium impact your heart health. Potassium keeps all your bodily functions in check by acting as an electrolyte to keep your cells, tissues, organs, and heart’s electrical system in working order.
Magnesium reduces attack risks, strengthens muscles and tissues, and prevents hypertension. If you notice your heart skipping, your doctor may want to test your mineral levels. “We try to correct what we believe to be the responsible mechanism,” says Dr. Willerson. “Even if it’s low potassium, we have to give them medication.”
Esophagus is located close to the heart. So people who are affected by acid reflux may develop heart palpitations that occur after a meal or when you are lying down.
Dehydration usually lowers your blood pressure thereby causing electrolyte imbalances. To set this right, the heart has to work harder, feeling as though it has skipped a beat.
Diabetics with low blood sugar levels are more likely to experience irregular heartbeat.
Medicines which contain ephedrine are known to cause ectopic heartbeat. Use of illicit drugs like marijuana may cause irregular heartbeat. Stimulant drugs like those used to treat ADHD and depression can sometimes cause heart palpitations that feel like skipped beats.
Skipped heart beat is common among people who smoke tobacco frequently. Some smokers have reported feeling disruptions in their heartbeat rhythms because of the effects of nicotine, a stimulant.
Eating too much stretches the stomach and causes your heart to flutter as it works to send blood to the stomach tissue to help in digestion. These palpitations may feel like your heart is skipping a beat, however, it is temporary.
PAC or PVC
Skipped beats may be caused by PAC (Premature Atrial Contractions) or PVC (Premature Ventricular Contractions).
People with arrhythmia (like atrial fibrillation) are more likely to experience irregular heartbeat.
Patients with hyperthyroidism experience irregular heart beat.
People with anemia generally experience this condition.
Irregular heartbeat is observed in people with chemical (electrolyte) problems in the blood. It can also be caused due to decreased blood supply to the heart (ischemia). People with diseases involving heart muscles experience irregular heartbeat. Anxiety and depression are other major causes of irregular heartbeat. People with mitral valve prolapse generally experience ectopic heartbeat.
Do Not Ignore
If skipped heart beat happens frequently and is accompanied by symptoms like chest pain, then it is advisable to consult a cardiologist. The nature of skipped beats is determined by an EKG (also known as ECG).
Beware of premature beats that occur frequently, are coupled, or beat three times in a row at a fast rhythm, all of which may signal a hidden health problem and pose an extra danger to your health.
High blood pressure, heart disease, and atrial fibrillation are just a few health conditions that premature beats could be indicating. “Most of the time they are benign, but we don’t miss those patients who have a structural problem of the heart or multiple extra beats from other areas of the heart,” says Dr. Hussein. “Everyone needs to be assessed by a healthcare specialist.”
A meta-analysis of 104 studies including 9 million participants, of whom 587,867 had atrial fibrillation, was conducted by research scientists in the University of Oxford in the United Kingdom and the Massachusetts Institute of Technology in the United States of America.
The results indicated that apart from stroke, irregular heart beat enhances the risk of developing heart failure (incident risk of 11 events per 1,000 participant years), all cause mortality (incident risk of 3.8 events per 1,000 participant years), ischemic heart disease (incident risk of 1.4 events per 1,000 participant years) and chronic kidney disease (incident risk of 6.6 events per 1,000 participant years).
Atrial fibrillation was found to be associated with a two-fold greater risk of mortality due to cardiac events, a 2.3-fold greater risk of stroke, and a five-fold higher risk of incident congestive heart failure. The results highlight the reach of atrial fibrillation beyond stroke, and caution against underestimating the consequences of an irregular heart beat on health.
A Case When Skipping Heart Rate Led to Stroke
Jill Enfield did not know that she had atrial fibrillation when stroke attacked her in October 2009. She had not even heard of atrial fibrillation.
She knew that her heart was not healthy. She was diagnosed with mitral valve prolapse, a heart valve problem that is known cause palpitations. So when her heart started acting oddly, she assumed that her condition was getting worse.
I kept feeling my heart skipping and having to cough to get it back into rhythm.— Jill Enfield, 59, a fashion photographer in New York City
"I kept feeling my heart skipping and having to cough to get it back into rhythm," says Enfield, 59, a fashion photographer in New York City.
She did not know that atrial fibrillation was the cause of her heart problems until months after her stroke. If Jill had known, she could have acted to prevent her stroke.
Experts are of the opinion that around 3 out of 4 strokes caused by atrial fibrillation can be prevented with blood thinners. Atrial fibrillation that is not diagnosed can increase the patient's risk of stroke 5 times.
If you've got someone who's had a stroke and there's no obvious reason, it often is atrial fibrillation that has not been recognized.— Gordon Tomaselli, MD, chief of cardiology and a professor at Johns Hopkins in Baltimore
"If you've got someone who's had a stroke and there's no obvious reason, it often is atrial fibrillation that has not been recognized," says Gordon Tomaselli, MD, chief of cardiology and a professor at Johns Hopkins in Baltimore and a spokesman for the American Heart Association.
Jill's stroke occured one morning when she tried to get up from bed, but realized that left leg had become immobile.
"I thought my leg was asleep," she says. "I went to move my leg with my left arm and I couldn't move my arm. I took my right arm and hit my husband to wake him up. I told him to call 9-1-1, that I was having a stroke."
At the hospital, physicians were not very optimistic. They told her husband that she may not walk again, and that they would never know what caused her stroke.
Jill defied the odds. By that evening she had begun to regain her mobility — not much, but some. After about a week in the hospital, she was discharged, but with no medicines and no physical therapy plan. "They just told me to call the doctor in seven weeks," she remembers.
Jill decided not to wait. She started physical therapy on her own, with the help of a physical therapist. These days, she feels she's getting back to normal. She still tires and becomes out of breath more easily than she did before the stroke, but her strength is returning.
"If I look in the mirror and smile hard, I can see one side is a little droopy, but no one else would notice," Enfield says.
After 2 months, when she consulted another physician, she got answers regarding the cause of her stroke. "When I told this doctor about my heart skipping, she said, 'That sounds like afib,'" Jill says.
To confirm her hunch and make a diagnosis, the physician sent Jill home wearing a portable heart monitor that would note whenever her heart skipped.
Her afib was confirmed and Jill began taking a blood thinner to reduce her chances of having another stroke, plus a medication to control her heart rate.
There is no history of atrial fibrillation in Jill's family. She lived a healthy lifestyle, was physically active. Why she developed afib is a mystery to her.
When I told this doctor about my heart skipping, she said, 'That sounds like afib.— Jill Enfield, 59, a fashion photographer in New York City
5 Common Cardiovascular Conditions
Rheumatic heart disease
Hypertensive heart disease
Ischemic heart disease
Inflammatory heart disease
- Heart beats regularly at the rate of 60 to 100 times per minute.
- Regular flow of electricity from SA node to AV node resulting in contraction of the heart muscle is known as a "sinus" beat.
- Skipped beats may be caused by PAC or PVC.
- People with arrhythmia are more likely to experience irregular heartbeat.
- Skipped heartbeats are not a cause of serious concern.
I believe every human has a finite number of heartbeats. I don't intend to waste any of mine.— Neil Armstrong