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Should I worry if my heart skips a beat?

Lankenau Medical Center August 23, 2017 Heart Health

Many of us have felt it on one occasion or another—a fluttering sensation in our heart, perhaps some palpitations, even a heavy pounding in our chest. What’s the cause and when is there reason to be concerned?

“Most people, at some point in their lives, experience these symptoms,” says Maribel Hernandez, MD, director of the women's heart program at Main Line Health, and American Heart Association 2018 Go Red for Women Heart Champion. “Much of the time, symptoms are brief and benign. The time to worry is when symptoms are sustained and/or if they are accompanied by lightheadedness, chest pain, or shortness of breath.”

Dr. Hernandez, who is board-certified in electrophysiology and cardiology, explains that there are several common causes for these sensations, known as heart arrhythmias. Arrhythmias occur when the electrical impulses that coordinate your heartbeats don't work properly, causing your heart to beat too fast, too slow, or irregularly.

Causes of heart arrhythmias

  • Medical conditions – Overactive thyroid is one of the conditions that may lead to heart rhythm problems which can be diagnosed and treated. Physicians will also check blood counts to rule out anemia or infection, and to measure the levels of certain chemicals such as magnesium and potassium, which may also cause rhythm problems.
  • Emotional or physical stress – Emotional or physical stress are also common culprits. Physical stress could be an illness, such as a viral infection, pneumonia, bronchitis, or recovery following surgery. In times of significant emotional stress, the body’s response is to release adrenaline, which can also cause an irregular heartbeat.
  • Excessive use of alcohol or caffeine –The excessive use of alcohol can cause heart arrhythmias, including atrial fibrillation, that can potentially lead to stroke. An excessive caffeine intake from coffee and soda may cause rhythm problems as well.
  • Hormonal changes – For some women, hormonal changes during pregnancy or perimenopause can create heart arrhythmias.

“When arrhythmias occur infrequently, they typically don’t damage the heart,” says Dr. Hernandez. “The time for concern is when arrhythmias are prolonged or cause symptoms. This may signal a more serious cardiac condition—perhaps a leaky valve, weak heart muscle, or a problem with the electrical fibers of the heart such as atrial fibrillation or long QT syndrome.”

Dr. Hernandez cautions that several of her patients assumed or were told that the fluttering or pounding they were experiencing regularly was due to anxiety or panic attacks. But upon her evaluation, she was able to identify electrical problems in the heart’s circuitry.

“If you have concerns, begin by talking with your primary care physician,” says Dr. Hernandez. “If you feel you’re not being heard, seek an evaluation from a cardiologist or a specialist in arrhythmias. I see many patients, especially women, who have been prescribed medication for anxiety when the cause of their symptoms is actually an arrhythmia.”

Diagnostic testing can include electrocardiograms, echocardiograms, stress tests, and event monitors that document a patient’s heartbeat over a longer period of time. If an arrhythmia is detected, numerous treatment options are available, from medications to catheter ablation procedures.

“Many arrhythmias can be easily cured and some don’t require treatment at all,” says Dr. Hernandez. “If you have any concerns, seek a thorough evaluation. And always, if any episode is accompanied by chest pain or trouble breathing, or you feel like you might faint, go directly to the ER or dial 911.”

Conveniently located just outside of Philadelphia, Lankenau Heart Institute has a highly specialized cardiac arrhythmia team known worldwide for their experience in the diagnosis and treatment of cardiac arrhythmias. To schedule an appointment with a Lankenau Heart Institute specialist, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.