‘Missed’ Heartbeats – Harmless or Deadly?

You’re sitting calmly, maybe reading or watching TV, and suddenly feel a flutter in your chest. Or worse, it feels as if your heart has stopped for a few seconds, then started up again.

The symptom you could be experiencing has been called “missed” heartbeat, “skipped” heartbeat, or heart “flutters.” Some people describe it as a hiccup, a pause, or a jump in their heart’s normal rhythm, or as if their hearts have “extra” beats. The fact is, it’s extremely common and usually no cause for concern.

The medical terminology for this syndrome is either premature ventricular contraction (PVC), or premature atrial contraction (PAC), depending on where in the heart they originate. PACs occur in the heart’s upper chambers (atria), PVCs in the lower chambers (ventricles). In general they are known as arrhythmias, meaning a heart beating out of normal rhythm.

The Heart Rhythm Society explains:

“The reason PACs or PVCs can sometimes be felt as a skipped beat is that the heart gets a premature signal to squeeze before it has had time to fill with blood. The resulting heart contraction does not produce blood flow to the body. A pause is felt, and the following heart beat is more forceful than usual. If the PAC or PVC is less premature, and the heart has had time to fill with blood before receiving the early signal to squeeze, an extra beat will be felt, rather than a skipped beat.”

The Washington Post, in a recent article on this phenomenon, reported, “PVCs and PACs are so common that, when study participants wear portable, rhythm-tracking devices called Holter monitors, virtually everyone gets at least one premature beat over a 24-hour period.

“We always see these early beats,” Dr. Gregory Marcus, a cardiac electrophysiologist at the University of California, San Francisco, said. “It’s part of being human.”

These irregular beats occur more often as people age, and in nearly all cases are harmless. The cause is a disruption in the heart’s electrical signal which regulates its normal rhythm. The triggers are largely unknown. Absent any heart disease, they have been blamed on caffeine, chocolate, alcohol, and anxiety, among other possible causes. Some people report experiencing them regularly for years with their doctors unable to pinpoint a reason.

Premature beats are common in healthy people of all ages, according to the Heart Rhythm Society. However, they can also be a sign of more serious problems. These can include thyroid problems, chronic lung disease, diabetes, and heart failure. Atrial fibrillation, which also causes an irregular or racing heart rate, and mimics the harmless kind, can raise the risk of a stroke.

Although some people can experience “skipped” or “missed” heartbeats as often as 1,000 times a day, if they are accompanied by shortness of breath, weakness, dizziness, chest pain or discomfort, lightheadedness, sweating, and fainting or near-fainting, they could signal an impending heart attack and should be treated as an immediate emergency.

While most cases of heart palpitations are benign, you should not hesitate to contact your concierge doctor to have them evaluated. We can perform a series of tests that will rule out more serious illness, provide advice on some ways to avoid them, and help set your mind at ease.


Facts and Fallacies About the Flu

Last week’s Center for Disease Control and Prevention (CDC) report on this year’s influenza outbreak was not positive: 49 states reporting widespread flu activity for the third week in a row; 37 children dead so far (the CDC does not track adult deaths); the highest level of activity reported since the 2009 H1N1 pandemic.

The Florida Department of health reports this week that flu activity throughout the state is high and continues to increase.

Your concierge doctors, in Jupiter, Florida, at MD. 2.0 have become concerned about the various flu-related myths that have been spreading like a virus. Here’s a quick quiz on some of the facts and misconceptions many have about the flu.

  1. You can get the flu from the flu shot

    False. You may get the flu even after you receive the shot because: (a) you became infected before you got the shot (it takes about two weeks to take effect); (b) you got a strain of influenza that wasn’t protected against in the shot; (c) the shot wasn’t effective for you. But studies have shown that even if you get the flu after getting the shot, the symptoms will likely be less severe.

  2. Pregnant women shouldn’t get it

    False. The flu shot is not only safe for pregnant women, it may also confer a measure of immunity to the baby for several months after birth.

  3. If you’ve already had the flu, you don’t need a shot

    False. There are several types of flu virus circulating, and you can still catch a type you haven’t already had. In addition, your immune system may be stressed from fighting off the first flu, so you may be more susceptible to attack from other viruses.

  4. You’re only contagious in the first 48 hours

    False. People can catch the flu from you a full day before you are experiencing any symptoms, and for up to a week after your symptoms subside. If you have the flu, stay home and sleep alone. If someone in your home has the flu, change and wash their bedding frequently, and disinfect the phone, remote controls, and other surfaces after they touch them.

  5. You can catch flu from breathing

    True. Yes, it’s important to wash your hands frequently with soap and water for at least 20 seconds, to use hand sanitizer when you can’t, and to avoid touching your eyes, nose, and mouth, the portals for the flu virus into your body. But it’s also the case that you can catch it simply from breathing the air from anyone within six feet of you who is sick. That’s why it’s vital that flu sufferers stay home.

  6. It’s not too late to get the flu shot

    True. Since no one can say for sure when this current outbreak will end, you can obtain a measure of immunity within two weeks. Although the typical flu season normally ends by the February-March timeframe, it can last as long as May. The current flu shot is at least 30% effective, and we believe 30% coverage is better than none at all.

  7. Getting a second shot will boost your immunity.

    False. The first shot will stimulate your immune system to fight off the virus. A second shot, which will contain the same strains as the first shot, will do nothing to boost your immunity further.

  8. The “stomach flu” is not really the flu

    True. Except in children, nausea, vomiting, and diarrhea-often called “stomach flu”-are not associated with influenza. Symptoms of the flu include: fever over 100.4 degrees; aching muscles; headache; a dry, persistent cough; chills and sweats; fatigue and weakness; and nasal congestion.

  9. Antibiotics will help once you get sick

    False. Antibiotics may be used once you’ve contracted the flu and you experience a secondary bacterial infection such as pneumonia, but they are totally ineffective against a virus. Instead, we will prescribe an antiviral such as Tamiflu to relieve your symptoms.

If you are experiencing symptoms of the flu, especially if they seem to be growing worse, see your primary care doctor as soon as you can.

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