I Think Something May Be Wrong With My Heartbeat

A cardiologist explains whether you need to worry when you feel your heart is off kilter

Adam Rosenbluth, M.D.,

AARP

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Published November 25, 2024

illustrated gif of a man with a heartbeat monitor

James Yates

I feel that my heart is sometimes skipping a beat. Is this dangerous?

First, if you’re experiencing increasingly frequent palpitations, fainting, dizziness, unusual sweating, lightheadedness or chest pains, consult your doctor right away.

Initially, your doctor will do a physical examination, ask questions about your medical history, and listen to your heart using a stethoscope. Your doctor may decide to perform an electrocardiogram (EKG), which is a fast and painless test that shows your heart’s rate, rhythm, strength and timing of electrical signals. You’d be surprised how many times I see extra beats, even runs of beats, when I’m performing an EKG in my office, and yet some of my patients don’t feel any of them. Other patients are highly sensitive to changes in their heart’s rhythm.

If the EKG is abnormal you may be referred for an echocardiogram (sonogram) to look at the architecture of the heart. Ultimately, your doctor may refer you to a cardiologist, a specialist in heart issues, or an electrophysiologist, a specialist in abnormal heart rhythms.

But if you feel like your heart is fluttering or skipping a beat, it’s most likely a condition called PVC or premature ventricular contraction. PVCs are a type of heartbeat that can occur in folks of all ages but is more common among older people. It may feel like your heart is skipping a beat, but PVCs are actually extra beats originating in your heart’s lower chambers, or ventricles. I see this condition all the time in my practice, and it's usually nothing to worry about.

If you’re experiencing fluttering in your heart, your doctor may fit you with a Holter monitor, which is a portable device that records the heart’s rate and rhythm during normal daily activities. These days, some personal devices like smartwatches can offer similar remote monitoring.

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It’s a good idea to review possible contributing factors with your health care provider. Lack of sleep, stress or anxiety, too much caffeine, smoking (whether it’s tobacco or cannabis), or taking a stimulant medication like a decongestant are possible triggers.

Sometimes the sensation of skipping a heartbeat can be caused by MVP or mitral valve prolapse. MVP occurs when your mitral valve doesn’t close properly during the heart’s contraction phase and allows the blood to flow backward into your left atrium. It’s important to know that this too is a fairly common condition that affects 2 to 3 percent of the U.S. population or 7 to 8 million people. MVP doesn’t damage the heart and it’s rarely serious, but it may cause frequent palpitations.

Even if your so-called skipped heartbeats are infrequent and you don’t have any other symptoms, it’s a good idea to make an appointment with your healthcare provider. You want to rule out other, more serious heart conditions such as atrial fibrillation or A-fib, where your heart beats erratically, or tachycardia, where your heart beats faster than normal. Both of these conditions will likely require medication or a procedure.

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If you’re dealing with the sensation of a fluttering heart or skipped beat, I also recommend trying to lessen stress with relaxation techniques like deep breathing or meditation, reducing your caffeine intake, exercising regularly, and eating a balanced diet. These practices all help with overall heart health. Also, be sure to stay hydrated, since palpitations can be caused by dehydration.

One more thing. You can try coughing, splashing cold water on your face, or bearing down as if you’re having a bowel movement to stabilize your heartbeat. All these actions are called “vagal maneuvers.” The vagus nerve runs from your brain stem to your belly and controls a number of involuntary actions in your body, including your heart rate. But it’s best to check first with your healthcare provider before trying vagal maneuvers.

You’re smart to pay attention to this issue and figure out what’s going on. Your heart deserves to be treated with attention and respect. It’s the organ that pumps blood through your body — and it’s vital for life.

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