Feels like my heart skips a beat

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If you feel like your heart has suddenly skipped a beat, it may mean you’ve had a heart palpitation. You may feel that your heart is skipping a beat, fluttering rapidly, or beating extremely hard. You may also feel that your heart is producing heavy, pounding beats.

Palpitations aren’t always harmful, but they can be worrisome if you’ve never experienced them before. For many people, the unusual beats will end and go away entirely on their own. Sometimes, however, medical treatment is necessary to prevent them from occurring again in the future.

The cause of heart palpitations isn’t always known. These harmless heart hiccups can happen from time to time without a real explanation.

Some common causes can be identified in people who have heart palpitations, though. The causes can be divided into two primary categories: non-heart-related causes and heart-related causes.

Non-heart-related causes

While a small heart flutter can happen to anyone, people with a high level of stress and anxiety are at greater risk for experiencing palpitations. The primary non-heart-related causes include:

• intense emotional feelings, including stress or fear
• anxiety disorders
• drinking too much caffeine or alcohol, or consuming too much nicotine
• use of illegal substances, including cocaine, amphetamines, and heroin
• hormonal changes as a result of pregnancy, menopause, or menstruation
• vigorous physical activity, including strenuous exercise
• some herbal or nutritional vitamins or supplements
• certain medications, including diet pills, decongestants, cough and cold medicines, and asthma inhalers with stimulants
• illnesses or conditions, including fever, dehydration, abnormal electrolyte levels
• medical conditions, including low blood sugar, low blood pressure, and thyroid disease
• food sensitivities or allergies

Heart-related causes

The primary heart-related causes include:

• arrhythmia (irregular heart beat)
• a prior heart attack
• coronary artery disease
• heart valve problems
• heart muscle problems
• heart failure

In many cases, palpitations are harmless, but they can be worrisome. A cause may be unknown, and tests might not return any results. If you continue to experience palpitations or if you’d like to be sure an underlying problem isn’t causing them, make an appointment to see your doctor.

At your appointment, your doctor will conduct a full physical exam and ask about your medical history. If they suspect something might be causing these symptoms, they’ll order tests. These tests can be used to help identify a cause for heart palpitations:

• Blood tests. Changes in your blood may help your doctoridentify possible problems.
• Electrocardiogram (EKG). This test records your heart’s electrical signals for a period of time. In some cases, you may have an EKG while you’re exercising. This is known as a stress test or treadmill test.
• Holter monitoring. This type of test requires you to wear a monitor for 24 to 48 hours. The monitor records your heart the entire time. This longer time frame gives your doctor a broader window of your heart’s activities.
• Event recording. If the palpitations are too sporadic for continuous monitoring, your doctor may suggest another type of device. This one is worn continuously. You’ll use a handheld device to begin recording as soon as you start experiencing symptoms.

Treatment for heart palpitations depends on the cause. For most people, palpitations will go away on their own, without any treatment. For others, treating the underlying cause of the palpitations can help stop or prevent them.

Avoid triggers with lifestyle changes

If anxiety or stress leads to the sensation, look for ways to reduce your worry. This may include activities such as meditation, journaling, yoga, or tai chi. If these techniques aren’t enough, work with your doctor to find a medication that can ease symptoms of anxiety.

Cut out problematic food and substances

Drugs, medications, and even foods can lead to palpitations. If you identify a substance that’s causing palpitations or sensitivities, try to remove it from your diet.

For example, cigarette smoking can lead to palpitations. If you discover that you have more heart palpitations when you smoke, stop smoking for a period of time and see if the sensation ends. We reached out to readers for real and practical tips to stop smoking.

Take care of your body

Stay hydrated, eat well, and get regular exercise. These components of a healthy lifestyle can also reduce your risk for heart palpitations.

Find a cause-specific treatment

If your heart palpitations are the result of a condition or disease, your doctor will work with you to find an appropriate treatment. These treatment options may include medications, catheter ablation, or electrical cardioversion.

Heart palpitations aren’t usually a reason for concern. If you experience the sensation of a fluttering, rapid, or pounding heart, know that most people won’t need treatment. The palpitations will likely go away on their own without any lasting issues.

However, if these sensations continue or if you’re worried they may be a sign of an underlying health issue, see your doctor. Tests can help your doctor quickly rule out any possible serious issues so that you can find a diagnosis and a treatment.