When your heart skips a beat
Some of us hope for our heart to skip a beat or flutter in the company of our special someone. For many people, however, sensations of skipped heartbeats or sustained fluttering sensations in the chest can be a medical problem.
Palpitation is a general term used to describe the feeling of an abnormal heartbeat. Many different types of heart rhythm problems, or arrhythmias, can cause these palpitations.
Arrhythmias occur when the heart’s normal electrical system, which controls your heartbeat, is short-circuited. The most common problems have complicated names: single extra heartbeats are called ectopic beats, PVCs, or PACs. Sustained fast rhythms from the upper chambers of the heart are called atrial fibrillation, atrial flutter and various types of supraventricular tachycardia. Much less common are life-threatening arrhythmias from the lower chambers of the heart, called ventricular tachycardia.
Symptoms of arrhythmia can vary quite a bit. Ectopic beats often feel like a “missed” or “skipped” beat because there is a sensation of a brief pause after the extra beat. On the other hand, sustained arrhythmias can create heart rates up to 200 beats per minute, or faster. Other than feeling a rapid pulse in the chest or neck, you could feel fatigue, shortness of breath, chest pain, lightheadedness or even fainting. With all kinds of arrhythmias, it’s even possible to have no symptoms whatsoever. Every person’s experience is different.
The great news is that there is so much we can do for a fluttering heart, although it’s not as easy as delivering flowers or a box of chocolate. The first step is to visit your doctor, who will try to find clues that point to certain arrhythmias. You may be asked to wear an event monitor that will record your heart rhythms when you have palpitations. Your physician may conduct a few tests to make sure the arrhythmia is not caused by other heart diseases, such as an enlarged or weak heart.
You should see a cardiologist or cardiac electrophysiologist (heart rhythm specialist) for a comprehensive plan of attack. Sometimes simple lifestyle changes are all that is required to end the problem.
If not, arrhythmias can often be suppressed by using daily medicines. A great alternative to medicine is cardiac ablation, which is a catheter-based outpatient procedure that can cure many arrhythmias. During an ablation procedure, a cardiac electrophysiologist inserts catheters into the heart and burns or freezes the abnormal electrical circuits that cause a patient’s arrhythmia.
Patients usually go home the same day and are cured. On the other end of the spectrum, people with severe or life-threatening arrhythmias related to heart disease might need pacemakers or implantable cardioverter-defibrillators.
So, the next time your heart skips a beat, remember it might not be because you-know-who sent you flowers. Listen to your heart and get it checked out.
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About the Author
Dr. Apoor Gami is a cardiac electrophysiologist at Advocate Good Samaritan Hospital and Advocate Medical Group – Midwest Heart Specialists. Dr. Gami completed his internship and residency in internal medicine with a fellowship in cardiovascular disease and cardiac electrophysiology and pacing at Mayo Clinic in Rochester, MN. He is board certified in internal medicine, cardiovascular disease and cardiac electrophysiology.