‘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.

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DASH Into the New Year for Your Health

If one of your New Year’s resolutions includes improving your overall health, one of the best ways you can achieve that is through a healthy diet. But what exactly does “a healthy diet” mean? Too many people think “eating healthy” means dining solely on rabbit food: carrots, lettuce, and a serving of water on the side. This doesn’t have to be the case. Your concierge primary care doctors at MD 2.0 Jupiter in Jupiter, Florida, prefer to call it “sensible eating,” and the payoffs can be enormous.

Take, for example, the DASH diet, which has been making people healthier for 20 years. Dietary Approaches to Stop Hypertension—the DASH diet—is recommended by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) because of its proven effect on lowering blood pressure in both hypertensive and pre-hypertensive patients.

In addition to improving cardiovascular health, the diet has been shown to help prevent cancer, reduce the incidence of diabetes, and improve kidney health. Finally, and not incidentally, one of the “side effects” of the diet is effective short-term and long-term weight loss. For its general effect on health, U.S. News and World Report has ranked the DASH diet the best diet for seven years in a row.


So what are the features of the DASH diet? Rather than strict rules, it provides more in the way of guidelines. These include: eating more fruits and vegetables, beans and nuts, fish, poultry, whole grains, and low-fat or nonfat dairy, and less full-fat dairy products, fatty meats, sugar-sweetened drinks, and sweets. Consumption of less salt (sodium) is also encouraged, but not required. However, many of the recommended foods on the plan are naturally low in sodium, so a good deal of salt reduction occurs incidentally.

The impetus for the research came when medical science was focused solely on the effect of salt on high blood pressure. Researchers who designed the DASH diet wanted to look at the way a diet high in nutrients, not just low in sodium, would impact hypertension. The results were gratifying.

The DASH diet is rich in fiber, calcium, potassium, and magnesium, nutrients which improve the body’s electrolyte balance, thus relaxing blood vessels as well as promoting excretion of excess fluid, both of which result in lower blood pressure. It emphasizes variety, portion size, and natural foods. And by including a good balance of lean protein, it helps satisfy hunger and maintain energy.

The diet was originally developed in the 1990s as part of a research study designed to see whether blood pressure could be reduced through a dietary approach. The results were remarkable. Subjects were able to reduce their blood pressure significantly in just two weeks, and the less salt that was consumed the lower the blood pressure achievement.

Later studies found that the DASH diet also served to lower total LDL and cholesterol, and reduced the risk of coronary heart disease and stroke, even years later.

So, if you’re looking for a diet that will improve your overall health as well as your waistline, you can’t go wrong with the DASH approach. There are myriad books available that provide the specifics, and sample menu plans can easily be found on the Internet. And of course, if you have specific questions about incorporating the DASH approach to healthier living, we can help you tailor the plan’s guidelines to meet your calorie requirements based on your weight, height, gender, age, and activity level.

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