4 reasons behind an irregular heartbeat
Knowing the underlying cause of arrhythmias can take the pressure off.
People like to exclaim, “My heart skipped a beat,” when they’re scared or excited. But an irregular heartbeat is much more common than you might think.
There are many different types, which can be temporary or permanent. And while these “butterflies” or occasional irregular heartbeats might not be a cause for concern, persistent or worsening symptoms might indicate a more serious health issue that needs evaluation and treatment.
“Fortunately for most people, irregular heartbeats are harmless, but some can be potentially life-altering,” says Pugazhendhi Vijayaraman, MD, cardiac electrophysiologist and director of cardiology at Geisinger Wilkes-Barre. “And because an irregular heartbeat affects how well your heart supplies your body with nutrients and oxygen through the blood it pumps, it’s important to talk to your doctor about symptoms and get to the bottom of the root cause.”
What is an irregular heartbeat?
An irregular heartbeat, also known as arrhythmia, occurs when the electrical signals that control your heart’s rhythm are disrupted. This disruption can lead to your heart skipping a beat or beating too fast, too slowly or in an irregular pattern.
A premature ventricular contraction, or PVC, is a common type of temporary arrhythmia. It’s the sensation that might lead you to say, “My heart skipped a beat.”
A PVC happens when the heart beats too early, which causes a stronger second beat. This causes a fluttering or pounding sensation in the chest. Most people have at least one PVC every day, and many don’t even notice it.
The most common type of treated heart arrhythmia is called an atrial fibrillation, or AFib, which can be dangerous and requires medical attention.
“AFib can cause rapid, irregular beats, sometimes more than 150 beats per minute,” says Dr. Vijayaraman. “So, blood doesn’t flow through the heart chambers normally, which can cause blood to pool and increase the risk for stroke, heart attack and blood clots.”
Irregular heartbeat symptoms
Sometimes you may feel your heart race or skip a beat, most likely due to strong emotions or exercise. But, possible signs of a more serious problem can include:
- Heart palpitations, or pounding in your chest
- Chest discomfort, pressure or pain
- Fatigue and weakness
- Dizziness and lightheadedness
- Shortness of breath
- Sweating
4 reasons behind an irregular heartbeat
Things like caffeine, alcohol and stress can cause small, temporary arrhythmias like PVCs. But there are other factors that can cause permanent arrhythmias, too.
Dr. Vijayaraman offers 4 potential causes of a persistent, irregular heartbeat:
Coronary artery disease
Your arteries are highways for oxygen and nutrients. However, fat, cholesterol and calcium can build plaques in the arteries, causing coronary artery disease. These plaques make it difficult for blood to flow efficiently and can put pressure on the heart.
“Coronary artery disease weakens the heart by putting it under too much pressure,” says Dr. Vijayaraman. “As the heart weakens, irregular heartbeats can develop and cause serious arrhythmias like AFib.”
Heart surgery
Heart surgery is a life-saving operation that can restore blood flow and help you get your life back.
But, operating on the heart can change the way the heart works, including the way it beats. Heart surgery can increase your risk of arrhythmias, so your doctors will often monitor your heart after surgery.
Changes in your heart muscle
If you’ve had a heart attack, you may have scar tissue on your heart muscle. This scar tissue can cause the heart to beat irregularly by restricting or changing the heart.
After a heart attack, there is also risk of cardiomyopathy or an abnormality of the heart. With cardiomyopathy, your heart may swell and make it harder to pump blood. This can also lead to life-threatening arrhythmia.
Electrolyte imbalance
You’ve likely heard of electrolytes in sports drinks, but they relate to your heart, too.
“Electrolytes are small traces of metal that conduct electricity, which allows the heart to beat,” explains Dr. Vijayaraman. “Sodium, magnesium, potassium and calcium are all examples of electrolytes. If the electrolyte levels in your blood are too high or too low, it can change the way your heart beats.”
Certain medications and unhealthy lifestyle habits, such as drinking too much alcohol and poor diet, can cause an electrolyte imbalance.
When to see your doctor about an irregular heartbeat
While PVCs are normally harmless, certain types of an irregular heartbeat, like AFib and VFib (ventricular fibrillation), are more serious. VFib can paralyze the heart — making it unable to pump blood. If left untreated, VFib can lead to cardiac arrest.
Get emergency medical attention if you feel:
- Dizzy
- Faint
- Short of breath
- Pain in your chest
These symptoms could be a sign of a severe arrhythmia or heart attack. Similarly, if you notice numbness on one side of your body, confusion, facial drooping and muscular weakness, these symptoms could be a sign of a stroke.
If you feel a persistent irregular heartbeat, your doctor can help diagnose the type of arrhythmia and monitor your heart.
“Your provider may refer you to an electrophysiology (EP) lab, where they can test, diagnose and treat arrhythmias,” says Dr. Vijayaraman. “Fortunately, arrhythmias are treatable with healthy lifestyle changes, medication or procedures to control irregular rhythms and help avoid a serious heart event.”
Next steps:
Learn about heart care at Geisinger
Find out how to check your blood pressure at home
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