We've all felt it: our heart skipping a beat in a moment of excitement or anxiety. Sometimes it happens randomly, and sometimes it's more than just one skipped beat. But is it dangerous? When should we worry? The concern is understandable, after all, we only have one heart. I've found that understanding how cardiologists think about the problem of the skipped beat can be helpful in reducing some of the worry associated with palpitations and in deciding when it makes sense talk to your doctor about your condition.
What is a skipped beat?
To understand what a "skipped beat" is, it's helpful to know about normal electrical conduction in the heart. Normally, there is an electrical highway from the top chambers (atria), through a gate between the top and bottom chambers, and then through the bottom chambers (ventricle) of the heart. The most common reason for a skipped beat is when something triggers either the top or the bottom chamber to activate early. As a result, you feel your heart beat early, and the heart briefly pauses to reset the electrical system. That brief pause is what you feel as a skipped beat. Almost all of these early activations (called premature atrial contractions – PACs – or premature ventricular contractions – PVCs) are because the heart is irritated by something. Dehydration, hunger and emotional or physical stress are the most common factors.
Are skipped beats dangerous?
Isolated PACs and PVCs are never dangerous, they're just a sign that your heart is responding to something. If we correct the underlying trigger, the skipped beats will go away. If they are a nuisance, we'll sometimes use a medication to make you feel the palpitations less, but this is mainly to improve your comfort.
So, when should I worry?
There are two features that raise our level of concern. First, if the palpitations continuously last a long time more than 10 minutes, for example – that suggests that the extra beats may be stringing together into a sustained rhythm. Second and more importantly, if you have worrisome symptoms severe dizziness/lightheadedness, episodes of passing out or profound shortness of breath – this is a sign that the condition is something more than PACs or PVCs.
What happens if I have those symptoms?
It depends. Certainly, if you have one of these two features (or even if you're worried and want to talk it through), it's a good idea to have a conversation with your doctor. Based on your unique circumstance, physicians may choose to do additional testing like a Holter monitor (a monitor you wear for 24 to 48 hours to measure every heart beat) or even a longer-term monitor. Or your doctor may decide to start you on a treatment. Alternatively, you may decide together that additional testing or treatment is not needed.
Do I need an EKG (electrocardiography) device?
There may be some circumstances when using one of those devices makes sense. But it's important to discuss this with your doctor first. Every device has its strengths and limitations, and using a device without understanding those limitations as they apply to your circumstance could result in data that we can't interpret. Or worse, it could result in a "false positive" a faulty result by the machine. This could mean significant unneeded testing or therapies without any benefit to you.
Most of the time, a skipped beat is just your heart reacting to something external. If it feels like something more, a quick conversation with your doctor can usually help you figure out if the skipped beat is a nuisance or something that requires more attention.
No comments:
Post a Comment