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What to do when your heart skips a beat
Dr. Apoor Gami
Updated: March 8, 2013 6:12AM
In February, some of us may be hoping for our heart to skip a beat or flutter in the company of our special someone. For many people, however, sensations of skipped heart beats or sustained fluttering sensations in the chest are a medical problem.
Palpitations is a general term used to describe a feeling of abnormal heart beats. Palpitations can be caused by many different types of heart rhythm problems, or arrhythmias.
Arrhythmias occur when the heart’s normal electrical system, which controls our heart beat, is short-circuited. Common problems include single extra heartbeats (called ectopic beats, PVCs, or PACs) and sustained fast rhythms from the upper chambers of the heart (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.
The symptoms one feels from arrhythmias 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 pulsation 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 listen to your story and examine you, trying to find clues that point to certain arrhythmias. You may be asked to wear an event monitor, which is like a mini-ECG that you can walk around with and activate to record your heart rhythms when you have palpitations. A few tests may be done 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, and some people choose or require this. 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, in people with severe or life-threatening arrhythmias related to heart disease, sometimes pacemakers or implantable cardioverter-defibrillators are required for successful treatment.
So, 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!~.
Dr. Apoor Gami is a cardiac electrophysiologist at Advocate Good Samaritan Hospital and Advocate Medical Group — Midwest Heart Specialists.
