What Does It Mean When My Heart Skips a Beat?

"Why does my heart skip a crazy beat?" Maybe it’s love, like Diana Ross sings about.

Most of the time, a fast-beating, pounding, or skipping heart isn't reason to worry. But sometimes these palpitations can be signs of trouble.

Many say a palpitation feels like a heaviness in the chest, head, or even the neck. Sometimes there’s a flip-flopping in the chest or the throat, or the heart may stop or skip for a brief second.

Do You Need to Call 911?

The answer is yes when you're also having shortness of breath, severe chest pain, heavy sweating, and dizziness, or you feel like you're going to pass out. You might be having a heart attack.

Don't drive yourself to the hospital. Let the ambulance come to you. Paramedics can begin treatment as soon as they arrive. You’ll get help sooner than if you go to the ER on your own.

Do You Need to See a Doctor?

Yes, if your pulse is more than 100 beats per minute and you've not been exercising and don't have a fever.

Yes, too, if you have:

Could It Be AFib?

Possibly. Atrial fibrillation is a type of arrhythmia, or irregular heartbeat.

Cells in your heart make electric signals that cause your ticker to pump at a regular pace.

If you have AFib, your heart's two small upper chambers (the atria) don't beat normally. Instead they beat too fast, with the electric signals triggered from different parts of the chambers. That causes an irregular rhythm and rapid thumping in your chest. You may also have dizziness, sweating, chest pain, or shortness of breath. Or, you might not have any symptoms.

You can manage AFib with your doctor's help. But if you don't get it treated, you’re at risk for a serious blood clot or a stroke.

Ask your doctor to check you for the condition if you think you might have it.


Could It Be PVCs?

Premature ventricular contractions are another common cause of irregular heartbeat.

PVC means the heartbeat that started in the two lower chambers of the organ (the ventricles) is beating before it should. You feel a regular beat, followed by an extra beat (the PVC), a pause, and then a stronger-than-usual beat. During the pause, the heart is filling with more blood than normal, which is why the next beat is extra-strong. It can happen in patterns or at random times.

Call your doctor if this happens often or goes on for several minutes.

What Else Should You Consider?

Are you stressed? When you're in a stressful situation, your body releases the hormone adrenaline. That temporarily speeds up your heart rate and breathing, and raises your blood pressure. If you're in the stressful situation for a long time, your heart may continue to beat faster than normal, or trigger extra beats.

Did you just exercise? Your heart rate rises when you work out hard. So you might feel palpitations before and after exercising, but not during -- that's because the extra heartbeats aren’t noticeable when your heart rates is up. When you stop working out, your heart rate slows down again, but your adrenaline level stays high, so you may feel your ticker beating extra-rapidly.

When could it be a warning sign of something serious? When you also have shortness of breath, chest pain, or extreme lightheadedness. In those cases call 911.

Have you been hitting the caffeine hard? You may have more of it in your system than you think. You'll find caffeine not only in coffee and tea, but also in:

  • Coffee drinks like lattes and cappuccinos
  • Sodas (even some non-cola ones)
  • Energy drinks
  • Chocolate
  • Some over-the-counter cold medications -- often the "non-drowsy" formulas

Caffeine causes your brain to release adrenaline, and that speeds up your heart rate.

Some people are more sensitive to it than others. But if you had a lot of caffeinated drinks in one day -- and you're also feeling tired and stressed out -- you could end up with heart palpitations and extra, early beats.


How Do You Figure Out the Cause?

Take notes on what was going on before your palpitations began. Bring the notes with you to your doctor’s appointment.

He may suggest you have an electrocardiogram (all called an ECG or EKG). This test shows the electric activity in your heart and its rhythm. This information can help your doctor understand what might be going on.

Having extra, early beats usually isn’t dangerous, but it can be frustrating. It affects some people's quality of life. But once you know what triggers it, you can take steps to treat it and feel better.

WebMD Medical Reference Reviewed by Suzanne R. Steinbaum, MD on October 29, 2017



University of Iowa Hospitals & Clinics: "Heart Palpitations: Frequently Asked Questions."

Main Line Health: "Heart Palpitations: How Common Are They and Should You Worry?"

American Heart Association: "Warning Signs of a Heart Attack;" "What is Atrial Fibrillation?;" and "What's the link between chronic stress and heart disease?"

National Library of Medicine:  "Heart Attack First Aid"and Atrial Fibrillation."

Johns Hopkins Heart and Vascular Institute: "When to Evaluate Heart Palpitations."

Brown University Health Promotion:  "Caffeine." 

Harvard Health Publications:  "Skipping a beat - the surprise of palpitations."

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