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Health Answers

What causes me to feel like my heart skips a beat?

Q. What causes me to feel like my heart skips a beat?

A. Many people occasionally feel their hearts racing, thumping, beating irregularly, or seeming to skip a beat. Laurence Epstein, chief of the cardiac arrhythmia service at Brigham and Women’s Hospital, says that the most common cause of a “skipped beat” is a heart palpitation, which is usually not a sign of an underlying health problem. Normally, every heartbeat is created by an electrical impulse from the heart’s pacemaker, a spot in the upper right chamber called the sinus node. Occasionally, Epstein explains, heart tissue outside the sinus node creates a rogue electrical impulse, making the heart contract. After this premature beat, there’s a longer-than-average pause, and the next beat is stronger than usual — many people feel this stronger beat rather than the premature one.

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“In most cases, premature beats are benign,” he says, and some people notice them more than others. But if you’re experiencing frequent heartbeat irregularities it’s important to identify the cause, because they could be a sign of a dangerous arrhythmia. To diagnose the problem, doctors may give you tests or have you wear a monitor so they can study the irregularity when it occurs.

Epstein says that frequent benign palpitations may be exacerbated by several possible factors, including caffeine, alcohol, stress, or a woman’s menstrual cycle, so it helps to notice potential triggers and moderate the ones you can. Frequent palpitations can be treated with medication or surgery if they interfere with your quality of life.

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