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What Causes the Heart to Skip a Beat: Heart Palpitations

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The human heart is a blood-pumping organ that helps in the circulation of oxygen-rich blood throughout the body. The pumping action of the heart which lasts for about a second is called a heartbeat. It happens in two parts. Firstly, when the upper two chambers of the heart get filled with blood, an electrical signal is transmitted that causes the heart to contract and push blood to the lower two heart chambers. In the second contraction of the heart, the blood is pushed to the lungs where it gets mixed with oxygen and then circulated all over the body. All this occurs automatically without the person being aware of his/her heartbeats. So, what does skipping a heartbeat means, and what causes it? Let’s find out. [1]

What are Heart Palpitations?

A heart palpitation is an unexpected or unexplained racing or pounding of the heart, or a feeling just like skipping a heartbeat. It is a kind of arrhythmia- an abnormal heart rhythm. The heart beats out of rhythm only when it fires signals from the wrong place at the wrong time.

Heart palpitations are sensations that are felt when the heart is beating either too slow, too fast, or irregularly. Most people experience heart palpitations once-in-a-blue-moon while others face a lot many in a day, sometimes so strong that they might confuse it with a heart attack. [2.3]

The Symptoms of Heart Palpitations

Heart palpitations are felt by most people as momentarily pounding, murmuring, flip-flopping, or racing of heart; extra or skipped heartbeat; a forceful or fluttering beat. These are felt in the chest or neck. The skipped beat is probably experienced by people as an early heartbeat. It happens when the heart contracts much before the ventricles get time to fill with blood. As a result, the body receives no or very little blood and that heart contraction is not at all felt as a beat. The next beat comes up as a forceful one as more volume of blood is then pushed out.

Other than these common symptoms, some people do experience serious symptoms. Talk to a heart specialist, if experiencing any of the following symptoms alongside heart palpitations:

  • Fainting
  • Light-headedness
  • Dizziness
  • Frequent or prolonged heart palpitations or when these worsen over time instead of getting improved
  • Chest pains like angina or tightness
  • Unusual sweating
  • Confusion
  • Troubled breathing or shortness of breath

In extreme cases of heart palpitations, people can have a sudden cardiac arrest. [3]

Causes of Irregular Heartbeat-Heart palpitations:

Heart palpitations can occur occasionally out of the blue and all of a sudden disappear too. Some people can notice them while they are drifting off to sleep while others may feel them when they are standing up after bending over. Heart palpitations can be linked with certain events, activities, emotions, or even advancing age. The skipping of a heartbeat can be an outcome of several factors, including:

1. Emotional or Psychological Triggers: Anxiety, stress, or a panic attack can lead to heart palpitations.

2. Lifestyle Triggers: Dehydration, excess consumption of alcohol, chocolate, or caffeine; strenuous exercise, and insufficient sleep all can result in Heart palpitations. A heart can even skip a beat of a person who is a smoker or an illegal drug abuser- like cocaine or maybe taking stimulants such as Sudafed.

3. Arrhythmias: These are the changes in the normal pattern of electrical impulses from the heart, resulting in irregular heartbeats. Some of them are harmless while others are life-threatening and require immediate medical attention. There are different kinds of arrhythmias such as: 

  • Tachycardia- Heart rate is faster than normal.
  • Bradycardia- A slow heart rate.
  • Ventricular tachycardia- A potentially serious cardiac condition wherein the heart rhythm is regularly fast and sometimes associated with blackouts or dizziness.
  • Supraventricular tachycardia: A rapid heartbeat that leads to dizziness.
  • Atrial fibrillation: It can result in irregular, fast heart rate and also increase the likeliness of stroke.

4. Heart Conditions: Some heart palpitations can be an indication of heart problems. The examples are-

  • Heart failure- This occurs when there is no effective pumping of blood through the heart and the heart chambers get dilated.
  • Congenital heart disease- It is the heart abnormality that a person has from birth.
  • Mitral valve prolapses- It is a condition wherein the valve between the upper and lower heart chambers does not close properly resulting in inefficient blood flow through the heart.
  • Hypertrophic cardiomyopathy- It is a heart condition wherein the heart muscles and its walls get enlarged.

5. Certain Medications: The medications that can trigger harmless heart palpitations include:

  • Antihistamines
  • Antidepressants
  • Asthma medications
  • Hypertension medications
  • Antibiotics
  • Antifungals

6. Hormonal Changes: Women can experience heart palpitations during their menstrual periods, pregnancy, or menopause because of hormonal fluctuations. An overactive thyroid can even result in heart palpitations.

7. Other Medical Conditions: The medical issues that can result in heart palpitations includes:

  • Low blood pressure
  • Anemia
  • Abnormalities in electrolytes
  • Thyroid storm
  • Low blood sugar level-Hypoglycemia
  • Fever
  • Low potassium. [1,2]

How to Stop Heart Fluttering?

The treatment of a heart skipping a beat depends upon its cause. If one experiences unexplained heart palpitations all of a sudden, then the following things must be done at first:

  • Stop smoking tobacco
  • Drink adequate amount of water
  • Stop drinking alcohol or limit its intake
  • Eat food regularly to ensure blood sugars are at level
  • Consult the concerned heart doctor to ensure that the current intake of medications and supplements are not causing heart palpitations
  • Go for a heart-healthy diet that contains whole grains, a range of fruits and vegetables, fish and seafood, nuts, legumes, and seeds
  • Be physically active

If the triggers of skipped heartbeats are anxiety or stress, the patient can try meditation, exercise, relaxation response, tai chi, yoga, or any other stress-busting activity. It may be a good idea to talk to a therapist

Medical Treatment Options Include:

  • A pacemaker- to regulate the heartbeat
  • Medications to reduce cholesterol, blood sugar levels, and hypertension
  • Mild electrical shock- to allow the heart to return to its normal rhythm
  • A cardiac defibrillator- an implantable device that monitors and corrects an irregular heart rhythm
  • Cardiac surgery- to remove a portion of the heart that is not functioning properly as expected. [1,2]

References:

  1. https://www.medicalnewstoday.com/articles/321793#what-is-a-heart-palpitation
  2. https://www.health.harvard.edu/heart-disease/skipping-a-beat–the-surprise-of-palpitations
  3. https://www.hopkinsmedicine.org/health/conditions-and-diseases/palpitations

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